Medications for Hypertension (HTN)

What is the goal of HTN meds?

Reduce cardiac AFTERLOAD by dilating blood vessels (decreases PVR), or decrease cardiac workload by decreasing volume, and contractility

Diuretics

• Ex. Furosemide (Lasix), hydrochlorothiazide

• Action: Prevent Na + H2O absorption; Promotes water excretion; Reduces blood volume

• Considerations: Monitor for hypokalemia

Beta Adrenergic Blockers

• Ex. Metoprolol (Lopressor), propanolol (Inderal)

• Action: Block sympathetic impulses to heart + blood vessels; Decreases HR and CO

• Considerations: Monitor P and BP for brady cardia; Indicated for pts w HF, CAD, diabetes

Calcium Channel Blockers

• Ex. Amlodipine (Norvasc), diltiazem (Cardizem)

• Action: Inhibit flow of calcium ions; Relax smooth arterial muscle; Vasodilation

• Considerations: Not indicated for pts w heart blocks; May cause tachycardia, constipation; Use w caution in pts taking digoxin or beta blockers

ACE inhibitors

• Ex. Lisinopril (Prinivil), enalapril (Vasotec)

• Action: Block angiotensin I from converting to angiotensin II; Dilates arteries

• Considerations: May cause release of kinins, causing chronic cough; Not indicated for pts w asthma

Angiotensin II Receptor Blockers (ARBs)

• Ex. Losartan (Cozaar), valsartan (Diovan)

• Action: Prevent action of angiotensin II; Relaxes blood vessels

• Considerations: Monitor for headache, dizziness, orthostatic hypotension

Direct Vasodilators

• Ex. Hydralazine

• Action: Vasodilation

• Used in MHTN

Alpha Adrenergic Blockers

• Ex. Terazosin

• Action: Blocks alpha receptors in vascular smooth muscle; Decrease vasomotor tone + dilation

• Considerations: Monitor for reflex tachycardia + palpitations