HTN & HLD drug matrix Flashcards
hydrochlorothiazide MOA
works on distal convoluted tubule to inhibit resorption of Na/K+/Cl -> results in decreased cardiac output and increased water loss
also decreases PVR
hydrochlorothiazide side effects
hypokalemia + lyte abnormalities
-orthostatic hypotension
-hyperuricemia
-may worsen renal insufficiency
-can elevate levels of glucose, cholesterol & tags
hydrochlorothiazide nursing considerations
-watch out for pt’s w/ gout
-give K+ sups & encourage K+ rich foods (potatoes, spinach, kale, beans, tomatoes, banana, avocado)
Furosemide MOA
inhibit the kidney’s ability to reabsorb Na in the loop henle -> more Na in urine which water will follow and increase urine output
water pills
Furosemide side effects
hypokalemia + lyte abnormalities
-dehydration
-hypotension
-ototoxicity
Furosemide nursing consideration
-monitor K+ levels (usually give a sup)
Spironolactone MOA
block the action of aldosterone -> K+ retention & excretion of Na & H2O
Spironolactone side effects
-hyperkalemia
-endocrine effects (deepened voice, period and erectile, hirsutism)
Spironolactone nursing considerations
-usually given w/ other diuretics
-only given PO
metoprolol/propranolol/carvedilol MOA
-increases nitric oxide = vasodilation
-blocks stimulation of beta 1 receptors = decreases HR and contractility
metoprolol/propranolol/carvedilol side effects
bradycardia
hypotension
-fatigue/lethargy
metoprolol/propranolol/carvedilol nursing considerations
-can mask hypoglycemia
-wean when discontinuing to avoid rebound HTN
-hold & call if HR <60 or systolic is <100
propranolol/carvedilol additional nursing considerations
do not give to pt’s w/ lung conditions or asthma d/t blocking of beta 2 receptors in the lungs
clonidine MOA
decrease sympathetic outflow resulting in decreased stimulation of adrenergic receptors (alpha & beta)
clonidine side effects
-drowsiness (give at night, v common)
-rebound HTN
-may worsen pre existing liver disease
clonidine nursing consideration
wean when discontinuing
doxazosin MOA
selective alpha 1 blockage (directly blocks SNS & decreases PVR) -> venous & arterial dilation
doxazosin side effects
-hypotension
-dizzinesss