Antihypertensives Flashcards
What is clonidine (catapress)?
- where does clonidine work
-what is the onset?
Alpha 2 agonist
suppresses the CNS system ( dec HR, dec BP)
fast onset 30-60 minutes
what should the nurse tell/watch/teach/monitor to the patient on Clonidine ?
xerostomia (dry mouth)
- chew gum , take sips of water
take at night
withdraw slowly 2-4 days (causes rebound HTN)
change patches every 7 days and apply on hairless area
use contraception
ACE inhibitors medicine examples
Lisinopril, Captopril, Enalapril
What is the mechanism of action of ACE inhibitors ?
converts Angiotensin 1 to angiotensin 2
suppresses aldosterone and promotes potassium retention
promotes sodium and water secretion
what are the primary effects of ACE inhibitors?
decreases BP by decreasing vascular resistance, decreases preload and work of heart
who should take ACE inhibitors?
HTN , HF, MI, hyperaldosterism, diabetes, neuropathy, glomerulopathy
What are the adverse effects of ACE inhibitors?
dry cough that reverses after therapy
fatigue/dizziness/headache
angioedema
impaired taste (craptopril)
hyperkalemia
renal failure
What to teach the patient on Captopril?
metalic taste in mouth
take on an empty stomach
need to take it twice a day for best BP control
What to teach the patient on Enalapril?
only BP in IV and PO forms
IV crisis use
need to monitor BP not HR
it is a prodrug and is not active until metabolized by the liver
ARB’s medications example
Losartan, Valsartan
What is the mechanism of action of ARB’s?
blocks the conversion of angiotensin 1 to angiotensin 2
stimulates aldosterone and retains water and sodium
Who should take ARB’s?
HTN, adjunctive HF, slows renal disease, and those who have already had MI’s
What are the adverse effects of ARB’s?
fatigue/dizziness/headache
GI upset
first dose phenomenon
hyperkalemia
renal damage
angioedema
What is the mechanism of action of Beta Blockers ?
Blocks cardiac beta receptors to decrease HR and force of contraction
What are the example medications of Beta Blockers
Atenolol, Metoprolol, Propanolol, Labetolol
What are the adverse effects of Beta Blockers?
Bradycardia/Bronchospasm
Arrhythmias/AV block
Dizziness/Depression
Fatigue
Impotence
Signs of Hypoglycemia masked
Hypotension
Who to be wary of when giving beta blockers too?
athletes and those with fever
who to NOT give beta blockers too?
those with
bradycardia
2nd 3rd degree heart block
SSS
acute decompensated HF
asthma and COPD
uncontrolled diabetes
Can you have beta blocker withdrawl?
Yes ,
do NOT abruptly stop them
it causes rebound hypertension and rebound tachycardia
arrhythmias, palpitations and MI
