Hypertensive Drugs Flashcards by Jamie Jaworski

Types of Antihypertensive drugs

Diuretics
ACE inhibitors
ARBs
Calcium channel blockers
Beta blockers
alpha blockers
Alpha-beta
central acting
direct vasodilators

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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

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ACE inhibitor drugs

lisinopril

enalapril

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Intended responses of ace inhibitors

vasodilation of blood vessels, diuresis, lowered blood pressure, decreased workload of heart

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ACE inhibitors are often prescribed with

diuretics

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Block production of substances that constrict blood vessels

ACE inhibitors

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Side effects of ACE inhibitors

Hypotension
taste disturbances
hyperkalemia
headache
persistent dry cough

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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

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Diffuse swelling of eyes, lips, tongue

Angioedema

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Check before: ACE inhibitors

i. If also taking diuretics, greater effect on BP will occur

ii. Ask about allergies to foods, dyes, drugs, etc

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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

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What are you checking after giving ACE inhibitors

K levels & I&Os

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Lifespan Considerations for ACE Inhibitors

At greater risk for postural hypotension

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Blocks the binding of angio II to their cell receptors. Leading to Vasodilation

ARBs

-“sartan”

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Drugs for ARBs

valsartan, losartan

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Intended responses of ARBs are the same as

ACE inhibitors

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Administering ARBs

a. Check before:

i. BUN and creatinine levels

ii. Kidney or liver problems

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M. Administering ARBs

Check after:

i. Swelling
ii. Urine output and weight
iii. Potassium levels

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Block calcium from entering muscle cells of heart and arteries; dilate arteries and decrease strength in heart contractions;

Calcium Channel blockers

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Calcium Channel blockers drugs we need to know

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diltiazem, nifedipine, verapamil

Calcium channel blockers intended responses

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(lowering BP)

i. Decreased heart rate
ii. Dec. force of heart contraction
iii. Dec workload of heart

Calcium channel blockers side effects

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Constipation, nausea, headache, flushing, rash, edema (legs), hypotension, drowsiness, dizziness

Adverse effects for calcium channel blockers

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Dysrhythmia, worsening heart failure (with verapamil and diltiazem), Stevens-Johnson syndrome

Administering Calcium Channel Blockers

Check before & check after:

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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

Hypertensive Drugs Flashcards

(48 cards)