HTN Medications

Lisinopril (Prinivil, Zestril)

ACE Inhibitor, Blocks conversion of angiotensin 1 to 2 leads to vasodilation, decreased BP, Side effects include cough, hyperkalemia, angioedema, hypotension, considerations: monitor K+ levels, renal function, avoid in pregnancy

Losartan (Cozaar)

ARB (angiotensin 2 receptor blocker), blocks angiotensin 2 leads to vasodilation, decrease in BP, side effects: dizziness, hyperkalemia, angioedema (less common than ACEIs), considerations: alternative to ACEIs if cough develops

Amlodipine (Norvasc)

calcium channel blocker (dihydropyridine), Inhibits Ca2+ influx in vascular smooth muscle leads to vasodilation, side effects: peripheral edema, headache, dizziness, considerations: avoid grapefruit juice, monitor for edema

Diltiazem (Cardizem)

calcium channel blocker (Non-dihydropyridine), slows AV conduction, decreases HR and BP, side effects: bradycardia, constipation, hypotension, considerations: monitor HR, avoid in heart failure with reduced EF

Hydrochlorothiazide (Microzide, HCTZ)

Thiazide diuretic, inhibits Na+ reabsorption in kidneys which leads to diuresis, decreases BP, side effects: hypokalemia, dehydration, hyperglycemia, dizziness, considerations: monitor electrolytes (K and Na), BP, hydration

Furosemide (Lasix)

Loop diuretic, inhibits Na+/Cl- reabsorption in loop of Henle which leads to potent diuresis, side effects: hypokalemia, dehydration, ototoxicity (high doses), considerations: give in AM to avoid nocturia, monitor electrolytes and BP

Spironolactone (aldactone)

aldosterone antagonist (K+ Sparing Diuretic), blocks aldosterone leading to decreases Na+ retention, preserves K+, side effects: hyperkalemia, gynecomastia, dizziness, considerations: monitor K+ levels, avoid high-K+ foods

Metoprolol (Lopressor, torpor XL)

Beta-blocker (selective), blocks b1 receptors leading to decreased HR and BP, side effects: bradycardia, fatigue, dizziness, erectile dysfunction, considerations: check HR before giving (<60 bpm, hold), taper off gradually

Propranolol (Inderal)

Beta-blocker (Non-selective), blocks b1 and b2 leading to decreased HR and BP, bronchoconstriction, side effects: fatigue, dizziness, bronchospasm (avoid in asthma), considerations: avoid in asthma/COPD, monitor HR

Clonidine (Catapres)

alpha-2 agonist, decreases sympathetic outflow leading to decreased BP, side effects: drowsiness, dry mouth, rebound HTN if stopped abruptly

Hydralazine (apresoline)

vasodilator, direct vasodilation of arteries leading to decreased BP, side effects: reflex tachycardia, headache, lupus-like syndrome, considerations: often used in hypertensive emergencies, monitor HR

Nitroprusside (Nipride)

vasodilator, direct arterial and venous dilation leading to rapid BP lowering, side effects: cyanide toxicity (prolonged use), hypotension, considerations: IV only, used in hypertensive crisis, monitor BP closely