Antihypertensives Flashcards
Ace Inhibitors
-pril
Lisinpril, captopril, Fosinapril, elanapril
Uses:
-HTN, HF, MI, diabetic neuropathy
Precautions/interactions:
- use with caution if using diuretic therapy
- monitor K+ levels
Side/adverse effects:
- persistent, non-productive cough
- angioedema/hypotension
- do not use in 2nd and third trimester
Interventions:
- assess weight, VS, hydration status
- assess BP in supine, sitting, & standing; prevent orthostatic hypotension
- assess renal function, coagulation
- take meds same time every day
- avoid hot tubs & saunas
- do not d/c abruptly
- captopril taken 1 hr. Before meals
- monitor for angioedema; administer epi 0.5 mL of 1:1,000 subq
Angiotensin II Receptor Blockers
- Sartan
Losartan, Valsartan, Ibesartan
Uses:
-HTN, HF, MI, diabetic neuropathy
Precautions/interactions:
- use with caution if using diuretic therapy
- monitor K+ levels
Side/adverse effects:
- persistent, non-productive cough
- angioedema/hypotension
- do not use in 2nd and third trimester
Interventions:
- assess weight, VS, hydration status
- assess BP in supine, sitting, & standing; prevent orthostatic hypotension
- assess renal function, coagulation
- take meds same time every day
- avoid hot tubs & saunas
- do not d/c abruptly
- monitor for angioedema; administer epi 0.5 mL of 1:1,000 subq
Calcium Channel Blockers
-dipine
Nifedipine, verapamil, diltiazem, amlodipine
Uses:
- angina, HTN
- Verapamil and diltiazam may be used to treat A-Fib, A-Flutter, and SVT
Precautions/interactions:
- use cautiously with digoxin and beta blockers
- contraindicated for patients with heart block, HF, or bradycardia
- do not consume grapefruit juice (toxic effects)
Side/adverse effects:
- constipation
- reflex tachycardia
- peripheral edema
- toxicity
Interventions/education:
- do not crush or chew sustained release tab
- administer IV injection over 2-3 min
- taper if d/cing
- monitor HR & BP
Alpha Adrenergic Blockers
-sympatholytics
Prazosin, doxazosin myelate
Uses:
- primary HTN
- doxazosin can be used to tx BPH
Precautions/interactions:
- increased risk of hypotension/syncope if given with other anti-hypertensives, beta blockers, or diuretics
- NSAIDs May decrease effect of prazosin
Side/adverse effects:
- dizziness
- fainting
Interventions/education:
- monitor HR & BP
- take at bedtime to minimize effects of hypotension
- notify prescriber immediately of adverse reactions
- consult prescriber before taking any OTC meds
Centrally Acting Alpha Agnoists
Clonidine, guanfacine, methyldopa
Uses:
- Primary HTN, can be used in combination with diuretics or other antihypertensives
- HTN crisis
- Severe cancer pain (parenteral administration via epidural)
Precautions/interactions:
- Contraindicated with anticoagulant therapy, hepatic failure
- do not administer MAOIs
- Do not administer methyldop through IV line with barbiturates or sulfonamides
- Use cautiously in CVA, MI, DM, major depression, or chronic renal failure
- Do not use during lactation
Side/adverse effects:
- Dry mouth
- drowsiness and sedation (resolves over time)
- Rebound HTN
- Black or sore tongue
- Leukopenia
Nursing interventions/education
- monitor for adverse CNS effects
- monitor CBC, HR, and BP
- Assess for weight gain or edema
- montior closely for rebound hypertension when medication is discontinued (48 hr)
- Never skip a dose
- take at bedtime to minimize effects of hypotension
- notify prescriber of any involuntary jerky movements, prolonged dizziness, rash, yellowing of skin
Beta Adrenergic Blockers
-olol
Cardio selective(beta 1): Metoprolol, Atenolol, Metoprolol succinate
Nonselective (beta 1 and 2): Propranolol, Nadolol, Labetalol
Uses:
- Primary hypertension
- Angina
- Tachydysrhythmias, HF, MI
Precautions/interactions:
- Contraindicated in clients who have AV block and sinus bradycardia
- do not dminister nonselective beta blckers to clients who have asthma, bronchospasm, or HF
- Propranolol may mask effects of hypoglycemia in clients who have DM
- Do not administer labetalol in sae IV line as lasix
Side/Adverse effects:
- Bradycardia
- Nasal stuffiness
- AV block
- Rebound myocardium excitation if stopped abruptly
- Bronchospasm
Interventions/education:
- Administer 1-2 times daily as prescribed
- do not d/c without provider consult
- do not crush or chew extended release tabs
- hold medication and notify provider if systolic BP is less than 100 mm Hg or pulse <60
- monitor clients who have DM for indications of hypoglycemia
Vasodilators
Nitroglycerin, Enalaprilat, nitroprusside, hydralyzine
Uses:
-hypertensive emegencies
Precautions/interactions:
- Clients who have hepatic or renal disease
- older adults
- electrolyte embalances
Side/adverse effects:
- dizziness
- headache
- profound hypotension
- cyanide toxicity
- thiocyanate poisoning
Nursing interventions/education:
- Nitroprusside may not be mixed with any medication
- Apply protective cover to container
- Discard unused fluid after 24 hr
- Proide continous ECG and BP monitoring
