Cardiac:Hypertensive To Lower Blood Pressure->

Question 1

Angiotensin- converting enzyme (ACE) inhibitors

Drugs that end in “pril”
-Lisinopril
-Captopril
-Enalapril

ACTION & CLINICAL PRIORITIES?

Answer 1

Action: Block the enzyme that converts angiotensin 1 into angiotensin 2-(a super powerful vasoconstrictor that will increase the BP.) Angiotensin 2 also causes the secretion of an additional blood pressure elevating hormone in the adrenal glands called aldosterone.)

-Clinical priorities: Avoid in African American patients due to increased risk of angioedema.
listen for a “dry hacking cough. Do not give it if the patient has a history of angioedema or renal impairment or renal impairement.
-Avoid during pregnancy can increase potassium levels.

Question 2

Angiotensin Receptor Blockers(ARBS)
End with “Sartan”
Losartan
Valsartan

Action & Clinical priorities?

Answer 2

Action: Blocks the effect of angiotensin 2 at the receptor sites

Clinical priorities: Arbs may raise potassium levels. Give at bedtime to better control blood pressure.
Avoid grapefruit juice with losartan

Question 3

Calcium channel blockers
generic names of the drugs:
-Amlodipine
-Nifedipine
-Verapamil
-Diltiazem

Action clinical priorities

Answer 3

Action: stops calcium from entering the myocardium muscles which promotes vasodilation.

Clinical Priorities :
-Nifedipine is safe to give during pregnancy.
-Do not give in clients with heart block.
-Do not give with grapefruit juice.

Question 4

Thiazide Diuretics:
Drugs that end in “Thiazide”
Hydrochlorothiazide
Chlorothiazide

Answer 4

Action: Increases the release of sodium and potassium which result in hypokalemia

Clinical prioritiesz;
-Avoid in clients who have sulfa allergy.
-causes photosensitivity
-administer it the morning to prevent nocturia.
-Decrease the effectiveness of anti diabetic medications
-Avoid giving with lithium.