Hypertension Medications Flashcards
What are ACE (Angiotensin-Coverting Enzyme) inhibitors used for?
Lower blood pressure by preventing conversion of angiotensin I to angiotensin II.
Prevent vasoconstriction and sodium and water retention.
Which class of hypertension medicines should you give the first dose at bedtime to minimize “first dose” syncope?
Your Alpha-Adrenergic Blockers.
Examples: doxazosin, prazosin, terazosin
What are some nursing considerations when giving ACE inhibitors?
- Monitor client for first dose syncope, persistent dry cough, hyperkalemia
- Monitor client for manifestations of angioedema, for example swelling of facial features and tongue, which would result in the closing of their airway
- Contraindicated in renal artery stenosis and pregnancy
- Report changes in WBC count
What are some examples of Beta-Adrenergic Blocking Agents?
End in “olol”
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Acebutolol
Atenolol
Metoprolol
Lopressor
Nadolol
Propranolol
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Inhibits flow of calcium ions across the cell membrane of vascular tissue and cardiac cells.
Relaxes arterial smooth muscle, lowering peripheral resistance through vasodilation.
Calcium-Channel Blockers
Examples of angiotensin-converting enzyme inhibitors (ACE)
End in “pril”
Benazepril Captopril Enalapril Fosinopril Lisinopril Ramipril Perindopril
Prevents vasoconstriction and sodium and water retention
ACE inhibitors
Block alpha-receptors in vascular smooth muscle.
Decrease vasomotor tone and vasoconstriction.
Reduce serum levels of low and very low density lipoprotein
Alpha-Adrenergic Blockers
Which class of hypertension medications are good for diabetics?
ACE inhibitors
Use is contraindicated in asthma, chronic lung disease, bradycardia, or heart block.
Beta-Adrenergic blocking agents
(This is because beta cells dilate the blood vessels so beta blockers will cause constriction, which can cause shortness of breath)
May cause constipation.
Calcium-channel blockers
End in “pine”
With exception of diltiazem and verapamil
Reduces blood pressure by preventing beta receptor stimulation in the heart, resulting in decreased heart rate and cardiac output.
Beta-Adrenergic Blocking Agents
End in “olol”
Interferes with renin release by kidneys, decreasing the effects of angiotensin and aldosterone.
Beta-Adrenergic blocking agents
End with “olol”
Stimulate the alpha2-receptors in the central nervous system to suppress sympathetic outflow to the heart and blood vessels.
Decreases cardiac output and vasodilation, reducing blood pressure.
Centrally acting sympatholytics
Ex: clonidine, guanfacine, methyldopa, reserpine
Dry mouth and sedation are common adverse effects.
Centrally acting sympatholytics
Reduces blood pressure by relaxing vascular smooth muscle and decreasing peripheral vascular resistance.
Often prescribed in combination with a diuretic or beta blocker because they can cause reflex tachycardia and fluid retention.
Vasodilators
Examples: hydralazine, minoxidil
Hydrochlorothiazide
Thiazide diuretics
Prevents tubular reabsorption of sodium, promoting sodium and water expiration and reducing blood volume.
Reduces systemic vascular resistance.
Thiazides diuretics
Example: hydrochlorothiazide
Nursing considerations include:
- Monitoring client for hypokalemia
- Preferred treatment for systolic hypertension in older adults
- Effective in African-American clients
Thiazides diuretics
Inhibits sodium and chloride reabsorption from the loop of Henle.
Acts on kidneys to increase flow of urine.
It may be used alone or in conjunction with other anti-hypertensives.
Loop Diuretics
Example: Furosemide (Lasix)
While on these medications you should monitor client for hyponatremia, HYPOKALEMIA, or hypomagnesemia.
Loop Diuretics (Lasix)
These receptor antagonist cause water and sodium excretions by the kidneys.
Potassium-Sparing diuretics
Example: spironolactone (Aldactone)
With ACE inhibitors = hyperkalemia
Potassium-Sparing diuretics
Example: spironolactone (Aldactone)
Inhibits 3-hydroxy-3-methylglutaryl coenzymes (HMG-CoA), a reductase, which results in less cholesterol biosynthesis.
Statins
Example:
Atorvastatin, fluvastatin, lovastatin, pravastatin
What is it very important to monitor with a patient on statins?
Liver functions tests.
Avoid in clients with liver disease or heavy alcohol consumption, teach client to avoid alcohol while taking.
Blocks vasoconstriction and promotes relaxation of blood vessels, thereby lowering blood pressure.
Angiotensin II receptor blockers (ARB’s)
End in “sartan”
Losartan
Valsartan
Nursing considerations for a patient taking ARB’s
**Monitor client for manifestations of angioedema.
•Hyperkalemia
•contraindicated in pregnancy
Potent vasodilator that dilate both arterial and venous smooth muscle. Dilation of veins reduces preload.
Nitrates
Example: nitroglycerin
To reduce the oxygen demands on the heart, have client lie down when taking this medication for chest pain.
Nitrates
Example: nitroglycerin
Causes the heart to be more forcefully and more slowly, improving cardiac output. (positive inotropic affect)
Cardiac glycosides
Example: digoxin
Side effects such as drowsiness, fatigue, dizziness, visual disturbances, anorexia, nausea, or vomiting may indicate toxic levels ==> digtoxicity
Cardiac glycosides
Example: digoxin
Administered to dissolve clots resulting in myocardial infarction or stroke, with quick restoration of circulation.
Thrombolytics (Clot Busters)
Example: Tissue plasminogen activator (t-PA)
