- can enhance effects of other hypertensives - least expensive - typically first line therapy for many

- beta 1 receptors; found in the heart called cardioselective beta receptors - beta 2 receptors: found in the lungs

- inc nitric oxide --> vasodilation response - block stimulation of beta 1 receptors --> decreases HR and contractility

Hypertension Medications Flashcards by Brooke Smithson

general diuretics MOA

inc urinary output
dec circulating vol
dec arterial resistance
lower BP to decrease cardiac output*

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diuretics extra info

can enhance effects of other hypertensives
least expensive
typically first line therapy for many

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hydroclorothiazide class

thiazide diuretic

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hydroclorothiazide moa

inhibits absorption of Na/K/Cl in distal convoluted tubules
- increases water loss which decreases cardiac output
relaxes arterioles
- dec peripheral resistance

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hydroclorothiazide side effects

electrolyte and metabolic disturbances
hypokalemia
orthostatic hypotension
may worsen renal insufficiencies
hyperuricemia
can elevate levels of glucose, cholesterol, and triglycerides

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furosemide class

loop diuretic

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furosemide moa

inhibits kidneys ability to reabsorb Na in loop of Henle
- Na goes into urine and water follows
- dec fluid in bv so dec cardiac output
- IV or PO

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furosemide side effects

hypokalemia
dehydration
hypotension
ototoxicity

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furosemide nursing considerations

monitor K levels
monitor output levels bc should have high output

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hypokalemia

low K (below 3.5)
- normal range: 3.5-5.0
- thiazide and loop diuretic common side effect

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why is hypokalemia problematic

K is needed for proper contractions of heart, w/out enough K, there is a disruption to proper cardiac function

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spironolactone class

potassium sparing diuretic

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spironolactone moa

block action of aldosterone
- K retention, Na water excreted

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spironolactone side effects

hyperkalemia which can cause endocrine effects like
- deepened voice, impotence irregular menstrual cycles, gynecomastia, hirsutism

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spironolactone nursing info

only given PO
usually given in combo with other HTN meds/diuretics to get more results and lower risk of hypokalemia
small dieresis and hypotensive

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sympatholytics general info

SNS blockers
- SNS usually vasoconstrictors so when blocked vasoconstriction is lessened
- dec peripheral vascular resistance

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beta blockers medications

metoprolol (selective)
propranolol (non selective)
carvedilol (alpha and beta blockers)

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beta blocker types

beta 1 receptors; found in the heart called cardioselective beta receptors
beta 2 receptors: found in the lungs

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beta blocker moa

inc nitric oxide –> vasodilation response
block stimulation of beta 1 receptors –> decreases HR and contractility

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side effects of beta blockers

fatigue/lethargy
-bradycardia
hypotension
can mask hypoglycemia

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beta blockers nursing considerations

wean when discontinuing
possibility of rebound HTN
do not use non selective blockers for pt with chronic lung problems like asthma
recognize risk for hypotension/bradycardia

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beta blockers general info

PO/IV
end in -olol
primarily treats HTN but also prescribed for cardiovascular disease

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beta blocker is short for

beta adrenergic blocker

centrally acting sympatholytic are aka

alpha-2 adrenergic agonist

centrally acting sympatholytic drug

clonidine

clonidine moa

dec sympathetic outflow --> decreases stimulation of adrenergic receptors - blocks both alpha and beta receptors which decreases bp

clonidine side effects

- drowsiness - rebound HTN - may worsen pre existing liver disease

clonidine nursing indications

- HTN - PO or transdermal patch - do not abruptly discontinue --> rebound HTN

doxazosin class

selective alpha-1 blockers

doxazosin moa

selective alpha-1 blockade - venous and arterial dilation

doxazosin side effects

hypotension and dizziness

doxazosin nursing info

- not first line treatment - tamsulosin (flomax) is also an alpha 1 block out but only used to treat BPH (benign prostate hypertrophy)

captopril and lisinopril class

ace inhibitors

captopril and lisinopril moa

blocks angiotensin converting enzyme - inhibits production of angiotensin-2 (powerful vasoconstrictor) - inhibits aldosterone secretion --> less water retention

captopril and lisinopril side effects

- first does hypotension - dry, persistent, cough - dizziness - rash - serious: angioedema

captopril and lisinopril nursing consideration

- not appropriate for pregnant women - use caution if pt has renal insufficiency - captopril can cause neutropenia - risk of hyperkalemia - often given in conjunction with thiazide diuretics

captopril and lisinopril other nursing info

- slows progression of LV hypertrophy - ends in -pril - drug of choice for DM so has some renal protective effects - safe first line therapy for hypertension and heart failure

losartan class

angiotensin receptor blocker (arb)

losartan moa

blocks action of angiotensin 2 AFTER it is formed - causes vasodilation - inc Na and water excretion

losartan side effects

generally well tolerated - some have risk of angioedema

losartan nursing considerations

- do not use if pregnant - use contraceptive if using - use caution if renal problems - only give PO - ends in -sartan

losartan indications

- HTN - heart failure - stroke progression

aliskiren class

renin inhibitor

aliskiren moa

direct inhibitor of renin which - induces vasodilation, dec blood vol, decreases SNS, and inhibitors of cardiac/vascular hypertrophy

aliskiren side effects

relatively well tolerated - GI discomfort - when given ACEi, watch for hyperkalemia especially if DM

aliskiren nursing considerations

- takes several weeks for full effect - do not take if pregnant - give PO

calcium channel blocker drugs

nifedipine nicardipine verapamil diltiazem

ca channel moa

block ca access to cells causes - dec contractility - dec conductivity of heart --> which decreases demand of o2

ca channel side effects

- hypotension, orthostatic hypotension - bradycardia - may precipitate AV block - headache - abdominal discomfort - peripheral edema

ca channel indications

HTN and chest pain (angina pectoris) - dilt and verapamil: heart rhythm disorders - nicardipine: refractive hypotension

ca channel nursing considerations

- best for elderly or blacks - diuretics can be give for peripheral edema - PO or IV

hydralazine class

vasodilator

hydralazine moa

work directly on arterial and venous smooth muscle and cause relaxation

hydralazine side effects

-hypotension -dizziness -headache - tachycardia - edema - dyspnea - GI upset

hydralazine nursing considerations

- treatment for HTN - PO usually w other hypertensive agents - IV in emergency or PO not tolerated