Cardiovascular Pharmacology

Angiotensin Converting Enzyme (ACE) Inhibitor

antihypertensive drug that blocks the production of angiotensin II resulting in arteriolar vasodilation, urinary excretion of sodium and water, urinary retention of potassium

What are some common adverse reactions of ACE inhibitors?

dry, unproductive cough, rash, metallic taste in the mouth, hyperkalemia, neutropenia

What are some nursing interventions for ACE inhibitors?

closely monitor BP, monitor for angioedema, monitor potassium levels, monitor WBC count

What are some patient education points for ACE Inhibitors?

signs of hypotension, instruct to report serious ADRs to provider, signs of hyperkalemia, instruct to avoid potassium containing salt substitutes

What are some contraindications for ACE Inhibitors?

hypotension, decreased renal function, bone marrow depression, autoimmune disorders

What are some interactions of ACE inhibitors?

potassium sparing diuretics, other antihypertensives, NSAIDs, lithium

ACE Inhibitor Nomenclature

-pril

Calcium Channel Blockers (CCB)

antihypertensive medications which block calcium channels in the smooth muscles in the vessels resulting in vasodilation

Reflex Tachycardia

increase in heart rate in response to lower blood pressure

What are some important adverse reactions of CCBs?

reflex tachycardia, angina, headache, facial flushing, peripheral edema, arrhythmias

What are some nursing interventions that relate to CCBs?

monitor for dizziness upon ambulation, monitor for peripheral edema, may be given with a BB to reduce reflex tach.

What are some contraindications of CCBs?

hypotension, second or third degree heart block, sick sinus syndrome

What are some interactions of CCBs?

grapefruit juice, rifampin, rifabutin, phenobarbital, phenytoin, carbamezapine, st. johns wart

CCB Nomenclature

-pine

Beta Blockers (BB)

antihypertensives which inhibit the action of beta 1 receptors to decrease heart rate and contractility, as well as decrease renin release from the kidney to decrease vasoconstriction and fluid retention

BB Nomenclature

-olol

What are some important adverse reactions of BB?

reduced CO, heart failure (SOB, edema, coughing)

What can sudden withdrawal of BB cause?

rebound excitation which results in angina and possible MI

What are some nursing interventions for BB?

monitor HR, and monitor for s+s of HF

What are some important contraindications for BB?

bradycardia, first degree heart block, moderate to severe HF, cardiogenic shock

What are some important interactions of BB?

anithypertensives, digoxin, antacids, hypoglycemics

Angiotensin II Receptor Blockers (ARBs)

treats hypertension and heart failure by blocking the adherence of angiotensin II to receptors leading to vasodilation

What are some side effects of ARBs?

headache, hyperkalemia, dizziness, hypotension, angioedema

ARBs Nomenclature

-sartan