Hypertension Drugs

Hypertension

blood pressure that is too high.

Diuretics help lower blood pressure by making the body lose sodium and water, which decreases fluid in the bloodstream and surrounding tissues.

Lisinopril

1. What the drug is:
ACE inhibitor (ACEI).

2. Use of the drug:

• Treats high blood pressure (hypertension).

• Used for congestive heart failure (CHF).

• ACE inhibitors are considered first-line treatment for CHF.

3. Frequency (FREQ):
Once a day.

4. Signs and symptoms (S/S) / Side effects:

• First-dose syncope (fainting)

• Dizziness

• GI side effects

4.What to be aware of:

• Lowers blood pressure.

• Decreases the body's salt and water load.

• Can cause fainting or dizziness, especially with the first dose.

5.Combination drug? If yes, what with?
Can be combined with a diuretic such as hydrochlorothiazide (HCTZ). A specific combination product is not listed for lisinopril in this slide.

Lisinopril/HCTZ (hydrochlorothiazide)

1. What the drug is:
A combination of an ACE inhibitor (lisinopril) and a diuretic (HCTZ).

2. Use of the drug:

• Treats high blood pressure (hypertension).

• Used for patients with heart failure (HF).

3.Signs and symptoms (S/S) / Side effects:

• Dizziness

• Electrolyte imbalances, such as potassium loss

4.What to be aware of:

• Lisinopril helps lower blood pressure.

• HCTZ removes sodium and water from the body, decreasing extracellular fluid and lowering blood pressure.

• Monitor for potassium loss and dizziness.

5.Combination drug? If yes, what with?
Yes. Lisinopril + hydrochlorothiazide (HCTZ) = Prinivil-HCT.

Valsartan

1. What the drug is:
Angiotensin II receptor blocker (ARB).

2. Use of the drug:

• Treats high blood pressure (hypertension).

• Used for heart failure (HF).

• Helps decrease blood pressure and the body's salt and water load.

3. Frequency (FREQ):
Once a day.

4. Signs and symptoms (S/S) / Side effects:

• First-dose syncope (fainting)

• Dizziness

• Gastrointestinal (GI) side effects

4.What to be aware of:

• Valsartan is an ARB, not an angiotensin-converting enzyme inhibitor (ACEI).

• It decreases blood pressure and salt and water load.

• The slides list fainting, dizziness, and gastrointestinal side effects.

5.Combination drug? If yes, what with?

• Sacubitril + valsartan = Entresto: Used for heart failure classifications II–IV. Improves quality of life and decreases hospitalizations due to heart failure.

• Valsartan + amlodipine = Exforge: A combination used to treat high blood pressure.

Losartan

1. What the drug is:
Angiotensin II receptor blocker (ARB).

2. Use of the drug:

• Treats high blood pressure (hypertension).

• Used for heart failure (HF) treatment.

3. Frequency (FREQ):
Once a day.

4.Signs and symptoms (S/S) / Side effects:

• First-dose syncope (fainting)

• Dizziness

• Gastrointestinal (GI) side effects

5.What to be aware of:

• Decreases blood pressure (BP).

• Decreases the body's salt and water load.

• The slide lists fainting, dizziness, and gastrointestinal side effects.

Spironolactone

1. What the drug is:
A potassium-sparing diuretic (water pill).

2. Use of the drug:

• Treats high blood pressure (hypertension).

• Helps the body remove extra water and salt.

3.Signs and symptoms (S/S) / Side effects:

• High potassium levels (hyperkalemia)

• Dizziness

• Nausea or vomiting

4.Nurse-to-patient teaching:

• Avoid potassium supplements or salt substitutes containing potassium unless instructed by the healthcare provider.

• Stand up slowly to help prevent dizziness.

5.What to be aware of:

• Potassium levels can become too high.

• Monitor potassium levels and kidney function.

6. Continue or discontinue:
Do not stop or change the medication without guidance from the healthcare provider.

Hydrochlorothiazide

1.What the drug is:
A diuretic (water pill), specifically a thiazide diuretic.

2.Use of the drug:

• Treats high blood pressure (hypertension).

• May be used for patients with heart failure (HF) or high blood pressure as part of combination therapy.

3.Signs and symptoms (S/S) / Side effects:

• Dizziness

• Electrolyte imbalances, such as potassium loss

4.What to be aware of:

• Causes sodium and water loss.

• Decreases extracellular fluid, which lowers blood pressure.

• Monitor for potassium loss.

5.Combination drug? If yes, what with?

• Lisinopril + hydrochlorothiazide = Prinivil-HCT.

• Hydrochlorothiazide is commonly combined with angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs).

Furosemide

1.What the drug is:
A diuretic (water pill).

2. Use of the drug:

• Treats high blood pressure (hypertension).

• Can be used alone or combined with other medications.

3.Signs and symptoms (S/S) / Side effects:

• Dizziness

• Electrolyte imbalances, such as potassium loss

4.What to be aware of:

• Causes sodium and water loss.

• Decreases extracellular fluid, which lowers blood pressure.

• Watch for potassium loss.

5.Combination drug? If yes, what with?

• May be used alone or in combination with other medications.

• Specific combination drugs are not specified in the provided slides.

Amlodipine

What the drug is:
A calcium channel blocker (CCB).

Use of the drug:

• Treats high blood pressure (hypertension).

• Relaxes blood vessel smooth muscle, causing vasodilation (widening of blood vessels).

• Decreases total peripheral resistance (TPR).

Signs and symptoms (S/S) / Side effects:

• Edema (swelling)

• Hypotension (low blood pressure)

• Headache

• Dizziness

• Increased heart rate (HR)

What to be aware of:

• Calcium channel blockers dilate coronary arteries.

• They are useful for all three types of angina (chest pain caused by reduced blood flow to the heart).

• The slides mention they are good for patients with low ejection fraction.

• They may cause a reflex increase in heart rate, especially nifedipine.

Combination drug? If yes, what with?

- Amlodipine + valsartan = Exforge.

Verapamil

What the drug is:
A calcium channel blocker (CCB).

Use of the drug:

• Treats high blood pressure (hypertension).

• Blocks calcium movement in smooth muscle cells, causing vasodilation (widening of blood vessels).

• Decreases total peripheral resistance (TPR).

Signs and symptoms (S/S) / Side effects:

• Atrioventricular (AV) node block

• Congestive heart failure (CHF)

• Constipation

• Dizziness

What to be aware of:

blocks calcium movement in smooth muscle cells.

• It widens blood vessels and decreases resistance to blood flow.

• Watch for the listed side effects.

Minoxidil

What the drug is:
A peripheral arterial vasodilator (a medication that widens arteries).

Use of the drug:

• Used for refractory hypertension (high blood pressure that is difficult to control with treatment).

• Relaxes the small arteries, decreasing total peripheral resistance (TPR) and afterload.

Signs and symptoms (S/S) / Side effects:

- Hypertrichosis (excessive hair growth).

What to be aware of:

• Used only for refractory hypertension, according to the slide.

• is also associated with the brand Rogaine.

Hydralazine

What the drug is:
A peripheral arterial vasodilator (a medication that widens arteries).

Use of the drug:

• Treats hypertension (high blood pressure).

• May be used during pregnancy.

• Relaxes small arteries, decreasing total peripheral resistance (TPR) and afterload.

Signs and symptoms (S/S) / Side effects:

• Reflex increase in heart rate (HR).

• Drug-induced systemic lupus erythematosus (SLE).

• Sodium and water retention is listed in the slide.

What to be aware of:

• relaxes the arteries by decreasing calcium movement into smooth muscle cells.

• a preferred medication for hypertension during pregnancy.

Metoprolol

What the drug is:
A beta-1 selective blocker (β₁ blocker).

Use of the drug:

• Treats high blood pressure (hypertension).

• May be used in some patients with congestive heart failure (CHF).

What to be aware of:

• Your slide says do not use in chronic obstructive pulmonary disease (COPD) and diabetes.

• Beta blockers may be used in some patients with heart failure.

Atenolol

What the drug is: Beta-1 blocker (β₁ blocker).

Use of the drug: Treats high blood pressure (hypertension). Also used for angina (chest pain).

Nurse-to-patient teaching: Do not discontinue abruptly! Do not suddenly stop taking the medication.

What to be aware of:

• Long half-life — stays in the body longer.

• Decreases the heart’s workload.

• Not used for variant angina.

Continue or discontinue: Do not stop abruptly.

Propranolol

What the drug is: Beta-1 and Beta-2 blocker (β₁ + β₂ blocker).

Use of the drug:

• Treats hypertension (high blood pressure).

• Treats certain abnormal heart rhythms (antiarrhythmic).

• Helps with atrial fibrillation (A-fib).

• Good for digoxin-induced arrhythmias.

Nurse-to-patient teaching: Do not discontinue abruptly! Do not suddenly stop taking it.

What to be aware of:

• Good oral absorption (PO = by mouth).

• Class II antiarrhythmic: slows electrical conduction through the atrioventricular (AV) node and increases its refractory period.

• Beta blockers decrease the heart’s workload.

• Not used for variant angina.

Continue or discontinue: Do not stop abruptly.

Labetolol

What the drug is: Beta-1 and Beta-2 blocker (β₁ + β₂ blocker) and Alpha-1 blocker (α₁ blocker).

Use of the drug:

• Treats hypertension (high blood pressure).

• Preferred medication for hypertension during pregnancy according to your slide.

What to be aware of:

• Decreases total peripheral resistance (TPR).

• Does not cause a reflex increase in heart rate (HR).

• Your slide lists beta blockers among drugs to avoid during pregnancy, but specifically lists labetalol as preferred. Remember labetolol is the exception listed.

Carvedilol

What the drug is: Beta-1 and Beta-2 blocker (β₁ + β₂ blocker) and Alpha-1 blocker (α₁ blocker).

Use of the drug:

• Treats hypertension (high blood pressure).

• Sometimes used for congestive heart failure (CHF).

What to be aware of:

• Decreases total peripheral resistance (TPR).

• Does not cause a reflex increase in heart rate (HR).