Hypertensive Drugs Flashcards
Types of Antihypertensive drugs
Diuretics ACE inhibitors ARBs Calcium channel blockers Beta blockers alpha blockers Alpha-beta central acting direct vasodilators
a. Blocks the production of enzyme needed to convert angio-I to angio-II
i. Slow production of angiotensin II
ACE inhibitors
ends in -pril
ACE inhibitor drugs
lisinopril
enalapril
Intended responses of ace inhibitors
vasodilation of blood vessels, diuresis, lowered blood pressure, decreased workload of heart
ACE inhibitors are often prescribed with
diuretics
Block production of substances that constrict blood vessels
ACE inhibitors
Side effects of ACE inhibitors
Hypotension taste disturbances hyperkalemia headache persistent dry cough
Adverse effects of ACE inhibitors
i. Fever/chills; hoarseness; swelling in face, hands, feet; trouble swallowing or breathing; stomach pain; chest pain; rashes and itching skin; yellow eyes or skin
Angioedema: Diffuse swelling of eyes, lips, tongue
Diffuse swelling of eyes, lips, tongue
Angioedema
Check before: ACE inhibitors
i. If also taking diuretics, greater effect on BP will occur
ii. Ask about allergies to foods, dyes, drugs, etc
Patient teaching with ACE inhibitors
i. Take drug at same time each day
ii. Do not drink alcohol (unless prescriber approved)
iii. Avoid salt substitutes
iv. Report side effects
What are you checking after giving ACE inhibitors
K levels & I&Os
Lifespan Considerations for ACE Inhibitors
At greater risk for postural hypotension
Blocks the binding of angio II to their cell receptors. Leading to Vasodilation
ARBs
-“sartan”
Drugs for ARBs
valsartan, losartan
Intended responses of ARBs are the same as
ACE inhibitors
Administering ARBs
a. Check before:
i. BUN and creatinine levels
ii. Kidney or liver problems
M. Administering ARBs
Check after:
i. Swelling
ii. Urine output and weight
iii. Potassium levels
Block calcium from entering muscle cells of heart and arteries; dilate arteries and decrease strength in heart contractions;
Calcium Channel blockers
Calcium Channel blockers drugs we need to know
diltiazem, nifedipine, verapamil
Calcium channel blockers intended responses
(lowering BP)
i. Decreased heart rate
ii. Dec. force of heart contraction
iii. Dec workload of heart
Calcium channel blockers side effects
Constipation, nausea, headache, flushing, rash, edema (legs), hypotension, drowsiness, dizziness
Adverse effects for calcium channel blockers
Dysrhythmia, worsening heart failure (with verapamil and diltiazem), Stevens-Johnson syndrome
Administering Calcium Channel Blockers
Check before & check after:
a. Check before:
i. Heart problems, blood vessel, liver, or kidney disease
b. Check after:
i. Report irregular heart rhythms, allergic reactions
c. Patient teaching:
i. Caution of hypotension
ii. Gradually wean off medication
a. Block effects of epinephrine (adrenaline) on cardiovascular system
i. Think of how your heart responds when you are startled!
beta blockers
Beta blockers decrease
HR & force of contractions
Lowers pulse & BP
Beta blockers end in
-olol metoprolol atenolol labetalol d. Classified cardio selective and non-cardio selective
Common side effects of beta blockers
Impotence, dizziness, light-headedness, insomnia, lethargy, weakness
i. Very slow heart rate, chest pain, severe dizziness or fainting, fast or irregular heart rate, dyspnea, cyanotic nail beds, seizures
ii. Affect diabetic patients’ blood glucose levels
iii. Cause or exacerbate asthma or congestive heart failure
Adverse effects of beta blockers
Administering Beta blockers
a. Check before:
i. Heart rate, blood pressure
ii. Daily weights
iii. Blood glucose levels
iv. History of asthma
b. Check after:
i. Heart rate
ii. Monitor for shortness of breath, edema
c. Patient teaching:
i. Techniques to take pulse and BP
ii. Report signs and symptoms
iii. Avoid orthostatic hypotension
iv. Do NOT discontinue suddenly—may cause heart attack
i. Artery relaxation and dilation
ii. Increase blood flow
iii. Lower blood flow
known as “alpha adrenergic blockers”
ends in -zosin
Alpha Blockers
Alpha blocker drugs
prazosin
terazosin
Side effects of Alpha blockers
i. Dizziness, drowsiness, fatigue, headache, nervousness, irritability, stuffy or runny nose, nausea, pain in arms/legs, hypotension, weakness
Adverse effects of Alpha blockers
i. Lower blood pressure too much
ii. Fainting
iii. Shortness of breath or difficulty breathing
iv. Irregular heart rhythm, chest pain
v. Swollen feet, ankles, or wrists
Alpha blockers admin
a. Check before:
i. Males taking any phosphodiesterase type 5 inhibitor erectile dysfunction drugs
b. Check after:
i. General responsibilities
c. Patient teaching:
i. Do not drive or use machines for 24 hours after first dose
ii. Weigh self twice a week, report gain
Alpha-beta blockers drugs
carvediolol
labetalol
Alpha-beta blockers should not be
given with drugs for erectile dysfunction; may result in profound hypotension
Stimulate CNS receptors to decrease constriction of blood vessels; lead to dilation of arteries and lower BP
Central-acting adrenergic Agents
Central-acting adrenergic agents examples
Clonidine
Methyldopa
Intended responses of central-acting
Vasodilation, lower blood pressure, decrease heart workload
Side effects & adverse effects: central-acting
d. Side effects: Drowsiness, lethargy, dry mouth, nasal congestion
e. Adverse effects: Myocarditis rare
a. Act directly on peripheral arteries causing them to dilate; leads to lower BP
b. Intended responses—lowered BP; decreased heart workload
Direct vasodilators
Direct vasodilators drugs
hydralazine, minoxidil
adverse effects of direct vasodilators
i. Stevens-Johnson syndrome (with minoxidil)
ii. Report sustained increase in pulse >20 beats/min to prescriber immediately
Administration of Direct Vasodilators
a. Check before:
i. Baseline weight
b. Check after:
i. Intake and output; swelling; lung crackles
c. Patient teaching:
i. Contact prescriber if >2 doses are missed
ii. Report heart rate increases
iii. Weigh self and check for swelling: report changes
Renin is an enzyme and hormone that converts angiotensin 1 to angiotensin 2, which is potent vasoconstrictor that raises blood pressure
Direct Renin Inhibitors
Direct renin inhibitor drugs
Aliskiren
Side effects of Aliskiren
side effects include rash, cough, and angio-edema
