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Verapamil
Calan
- Blocks calcium
- reducing AV conduction
Adverse effects of Calcium channel blockers
Verapamil
- Constipation
- Dizziness
- Facial flushing
- Headache
- Edema of ankles
- Gingival hyperplasia
- Heart block
Calcium channel blockers
Nifedipine
- Vasodilation
- Reflex cardiac stimulation
- Major indications
- Angina pectoris
- Hypertension
- Migraine headaches
- Same Adverse Effects as Verapamil
Antihypertensive Drugs—
Drugs Acting on the Renin-Angiotensin System
- Regulation of blood pressure
- Regulation of blood volume
- Regulation of electrolyte balance
Regulation of Blood Pressure by the Renin Angiotensin System
Angiotensin II
- Action
- Vasoconstrictor
- Release of aldosterone
- Alters cardiac and vascular structures
- Formation
- Renin catalyzes angiotensin I from angiotensinogen-->Renin
- Angiotensin converting enzyme (Kinase II)
- Regulation of blood pressure
- Tissue effects
Angiotensin-Converting Enzyme Inhibitors (ACE)
Captopril
*"opril" in name indicates an ACE drug.
- Uses
- Hypertension
- Heart failure
- Adverse Effects
- Cough: primary side effect.
- First–dose hypotension (take at bed time)
- Hyperkalemia (K⁺ retension)
Angiotensin II Receptor Blockers (ARBs)
Losartan (Cozaar)
- Hypertension
- Heart failure
- Adverse effects
- Dizziness
- Birth defects*
What are the differences in the Rx's chosen to treat hypertension based on race?
- Whites
- ACE inhibitors
- Beta Blockers
- Blacks
- Diuretics
- Ca Channel Blockers
Nursing Implications for administering Antihypertensive drugs.
- Monitor BP prior to and during therapy
- Monitor and caution patient concerning postural hypotension (each time a new Rx is added, chance for orthostatic hypotension increases)
- Assess for edema
- Monitor lab values
- K
- Na
- Ca
Fundamentals of Antihypertensive drug therapy
- Lifestyle changes first
- Begin with single drug (Diuretic or beta blocker)
- Add another drug or substitute drug to produce adequate response
- Then add another drug if needed
- Each should come from a different class
- Start with low dose and gradually increase
- Clients with co-existing disease
- Avoid drugs that would make pre-existing conditions worsen
What is step-down therapy as related to antihypertensive drug therapy?
- After 1 year, attempt to reduce dosages and number of drugs.
- Those who would be considered for step-down are:
- Well controlled BP
- Low pretreatment DBP
- No end organ disease
- Monotherapy
- Lifestyle changes have been successful
Individualizing therapy
- Children
- --Secondary HTN more prevelent
- --Do not sue ACE I's or ARB's in sexually active girls
- Elderly
- --65% incidence in those over 60.
- Diabetics
- --Probably will be hypertensive just because of the metabolic effect of teh disease.
Hypertensive emergencies
- DBP>120 mmHg
- Treatment
- --Sodium nitroprusside
- --Nifedipine
- --Labetolol
- --Diazoxide
- --Trimethapham

Author

alyn217

159382

Card Set

Pharmville

Description

Antihypertensive drugs

Updated

2012-06-25T20:03:38Z

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