hypertensive drugs (broadhead) Flashcards
adrenergic neuron blockers prototype name
reserpine (Serpalan, Reserpine); sympatholytic
action of reserpine
makes norepinephrine unavailable
indications for reserpine
hypertension (not first line of choice due to severe adverse effects)
side effects of reserpine
severe depression and risk for suicide, bradycardia, orthostatic hypotension, gastric iritation, diarrhea
adverse side effects of reserpine
suicide risk
contraindications of reserpine
pregnancy category D, peptic ulcer disease, do not use with MAOIs
special considerations for reserpine
monitor for depression, monitor BP and HR, report dizziness
centrally acting alpha2 agonists prototype name
clonidine (Catapres); sympatholytic
action of clonidine
inhibits innervation of sympathetic neurons in the CNS resulting in bradycardia and decreases cardiac output, causes vasodilation
indications for clonidine
hypertension, severe pain, prophylaxis for migraine headaches, dysmenorrhea, ADHD
side effects for clonidine
drowsiness, dizziness, dry mouth, rebound hypertensive crisis if abruptly discontinued
adverse effects of clonidine
do not abruptly discontinue, angioedema
contraindications of clonidine
anticoagulant therapy, pregnancy category c
special considerations for clonidine
monitor CNS effects, take at bedtime
alpha1 adrenergic blockers prototype name
doxazosin (Cardura); sympatholytic
action of doxazosin
blocks alpha 1 adrenergic receptors (blocks vasoconstrictive effects) resulting in both venous and arteriolar vasodilaiton
indications of doxazosin
hypertension, benign prostatic hypertrophy (BPH)
side effects of doxazosin
orthostatic hyposension, reflex tachycardia, headache
adverse effects of doxazosin
dysrhythmias
contraindications of doxazosin
history of syncope, children
special considerations for doxazosin
monitor BP, take drug at bedtime, do not take with sildenafil (Viagra) may increase risk for hypotension
prototype for beta adrenergic blockers
atenolol (tenormin) and metoprolol (lopressor); sympatholytic)
action of atenolol and metoprolol
block cardiac beta1 receptors resulting in decreased HR and contractility (causes decreased cardiac output and supresses reflec tachycardia); blocks renal beta1 receptors decreasing release of renin; decreases peripheral resistance of blood vessels
indications of atenolol and metoprolol
hypertension, angina pectoris, decreases mortality following MI, cardiac dysrhythmias, heart failure (only 2 including metoprolol)
side effects of atenolol and metoprolol
bradycardia, heart failure (shortness of breath, edema, cough at night), rebound excitation causing angina or MI with sudden withdrawl
adverse effects of atenolol and metoprolol
cardiac arrest, agranulocytosis, bronchospasm
contraindications of atenolol and metoprolol
bradycardia, severe heart failure, cardiogenic shock
special considerations for atenolol and metoprolol
monitor HR is
alpha/beta blockers prototype name
carvedilol (Coreg); sympatholytic
action of carvedilol
blocks peripheral alpha1 receptors resulting in arteriolar vasodilation; blocks cardiac beta1 receptors resulting in decreased HR and contractility; blocks kidney beta1 receptors resulting in decreased release of renin
indications for carvedilol
hypertension, heart failure along with digoxin, ACE inhibitors and diuretics, prolongs survival after and MI
side effects for carvedilol
dizziness, hypotension, bradycardia, decreased cardiac output
adverse effects for carvedilol
Stevens-Johnsons syndrome, folic acid deficiencies
contraindications for carvedilol
severe heart failure, COPD, severe bradycardia, cardiogenic shock
special considerations for carvedilol
monitor BP, HR if
ACE inhibitor prototype name
captopril (Capoten); RAAS
captopril actions
blocks production of angiotensin 1 causing arteriolar vasodilation, urinary excretion of NA and H20
inddications for captopril
hypertension, heart failure, diabetic nephropathy and LV dysfunction following MI
side effects of captopril
severe hypotension with 1st done, dry, nonproductive cough due to increased bradykinin, rash, metallic taste, hyperkalemia, neutropenia
adverse effects of captopril
blood dycrasias, allergic reaction, bronchospasm, angioedema
contraindications of captopril
pregancy category D, K sparing diuretics, liver disease
special considerations of captopril
monitor BP, monitor for cough, rash and metallic taste, monitor LFTs, electrolytes and CBC
ARB prototype name
losartan (Cozaar); RAAS
losartan actions
blocks angiotension 2 receptors causing arteriolar vasodilation, urinary exretion of NA and H2O and urinary retention of K
indications for losartan
hypertension, prevents stroke, manages diabetic nephropathy, treats heart failure, prevents migrane
side effects of llosartan
headache, insomnia, severe hypotension with 1st dose
adverse effects of losartan
angioedema, CVA, renal failure, thromobytopenia
contraindications of losartan
pregancy category D, children
special considerations for losartan
monitor BP, report CNS effects, report fainiting or dizziness
calcium channel blocker prototype name
nifedipine (Aldat, Procardia) and verapamil (Calan)
actions of nifedipine and verapamil
blocks Ca channels in muscle cells of peripheral and cardiac arterioles and cardiac arteries resulting in arteriolar vasodilation, decreased BP, increased coronary perfusion, indirectly increases HR
indications for nifedipine and verapamil
hypertension, stable angina and variant angina
side effects of nifedipine and verapamil
reflec tachycardia causing increased angina in client with angina, gingival hyperplasia, lightheadedness, facial flushing, peripheral edema of feet and legs, hypotension
adverse effects of nifedipine and verapamil
Stevens Johnsons syndrome, dysrhythmias, heart failure
contraindications of nifedipine and verapamil
acute MI, unstable angina, GI obstruction, cardiogenic shock, severe heart failure
special considerations of nifedipine and verapamil
give beta blocker to prevent tachycardia, monitor HR, BP (hold for
thiazide diuretics prototype name (heart failure)
hydrochlorothazide (HydroDiurel)
action of hydrochlorothiazide
blocks Na and Cl resorption causing increased excretion of Na and Cl, increases excretion of water/output, increases excretion K
indication of hydrochlorothiazide
heart failure, hypertension, cirrhosis of the liver and renal failure
side effects of hydrochlorothiazide
fluid and electrolyte imbalances, hyperglycemia, increased uric acid levels, hypokalemia, nausea, vomiting, diarrhea
adverse effects of hydrochlorothiazide
hepatitis, uremia, agranulocytosis, neutropenia
contraindications of hydrochlorothiazide
allergy to sulfa and thiazides, electrolyte imbalances
special considerations for hydrochlorothiazide
monitor serum electorlytes, monitor uric acid levels, each high potassium foods
prototype name for direct acting vasodilators
hydralazine (Apresoline) and nitroprusside (Nitropress)
action of hydralazine and nitroprusside
dilates arterioles resulting in decreased peripheral resistance, decreased BP, increases HR, increases contractility
indications for hydralazine and nitroprusside
moderate to severe hyptertension, hypertensive crisis, short term management of heart failure
side effects of hydralazine and nitroprusside
headache, palpitations, SLE like syndrome (facial rash, joint pain, fever, nephritis, pericarditis), fluid retention,edema
adverse effeccts of hydralazine and nitroprusside
do not abruptly withdraw, may cause hypertensive crisis, bone marrow suppression, shock
contraindications of hydralazine and nitroprusside
rheumatic heart disease, MI, tachycardia
special considerations for hydralazine and nitroprusside
monitor BP, HR, may add beta blocker for tachycardia, taper dose
