Drugs Affecting Blood Pressure

Flashcards based on lecture notes about drugs affecting blood pressure

Stroke Volume

Amount of blood pumped out of the ventricle with each heartbeat

Total Peripheral Resistance

Resistance of the muscular arteries to the blood being pumped through

Renin-angiotensin-aldosterone system

System that affects blood pressure

Aldosterone

Increases sodium and water reabsorption by the tubules of the kidney, resulting in increased blood volume.

Risks of Coronary Artery Disease Related to Hypertension

Thickening of the heart muscle, increased pressure generated by the muscle on contraction and increased workload on the heart.

Conditions Related to Untreated Hypertension

Coronary artery disease, cardiac death, stroke, renal failure and loss of vision.

Factors Known to Increase Blood Pressure

High levels of psychological stress, exposure to high-frequency noise, high-salt diet, lack of rest and genetic predisposition

ACE Inhibitors

Medications that reduce production of angiotensin II by blocking the conversion of angiotensin I to angiotensin II and increasing levels of bradykinin.

Expected Pharmacological Action of ACE Inhibitors

Vasodilation, excretion of sodium and water, retention of potassium, and reduction in pathological changes in blood vessels and heart.

Therapeutic Uses of ACE Inhibitors

Hypertension, heart failure, myocardial infarction, diabetic and nondiabetic nephropathy, and prevention of MI, stroke, or death in high-risk clients.

Complications of ACE Inhibitors

First-dose orthostatic hypotension, cough, hyperkalemia, rash, altered taste, angioedema and neutropenia.

Contraindications of ACE Inhibitors

Allergies, impaired renal function, pregnancy, lactation and CHF.

Client Education Regarding Diuretics and ACE Inhibitors

Temporarily stop taking diuretics 2 to 3 days before starting ACE inhibitors.

Client Education Regarding Antihypertensive Medications and ACE Inhibitors

Dosage of medication might need to be adjusted if ACE inhibitors are added to the treatment regimen.

Nursing Actions Regarding Lithium and ACE Inhibitors

Monitor lithium levels to avoid toxicity when taking ACE inhibitors.

Nursing Actions Regarding NSAIDs and ACE Inhibitors

Avoid concurrent use of NSAIDs with ACE inhibitors.

Client Education Regarding Taking ACE Inhibitors

Take captopril and moexipril at least 1 hr before meals; other ACE inhibitors can be taken with or without food.

Client Education Regarding Angioedema and Renin Inhibitors

Monitor for rash and angioedema. Stop medication and notify provider, or call 911 for severe manifestations.

Angiotensin II Receptor Blockers (ARBs)

Medications that block the action of angiotensin II in the body, resulting in vasodilation and excretion of sodium and water.

Manifestations of Angioedema

Skin wheals and swelling of tongue and pharynx

Therapeutic Uses of Angiotensin II Receptor Blockers

Hypertension, heart failure, stroke prevention, delaying progression of diabetic nephropathy, protecting against MI, stroke, and death in individuals unable to tolerate ACE inhibitors, reducing mortality following an acute MI and slowing the development of diabetic retinopathy.

Complications of Angiotensin II Receptor Blockers

Angioedema, fetal injury and hypotension

Contraindications of Angiotensin II Receptor Blockers

Pregnancy and bilateral renal stenosis or single remaining kidney.

Renin Inhibitor

Medication from new class of drugs for treating hypertension which directly inhibits renin, leading to decreased plasma renin activity and inhibiting the conversion of angiotensinogen to angiotensin I

Complications of Renin Inhibitors

Angioedema, rash, cough, hyperkalemia, diarrhea and hypotension.

Contraindications of Renin Inhibitors

Pregnancy and hyperkalemia

Calcium Channel Blockers

Medications used to decrease BP, cardiac workload, and myocardial oxygen consumption.

Actions of Calcium Channel Blockers

Inhibits the movement of calcium ions across the membranes of cardiac and arterial muscle cells

Complication of Nifedipine

Reflex tachycardia

Nursing Actions for Nifedipine and Reflex Tachycardia

Monitor clients for an increased heart rate and administer a beta blocker (metoprolol) to counteract tachycardia.

Complications of Verapamil and Diltiazem

Orthostatic hypotension and peripheral edema.

Nursing Actions Verapamil and Diltiazem

Monitor blood pressure, edema, and daily weight. A diuretic can be prescribed to control edema.

Suppression of Cardiac Function

Bradycardia, heart failure.

Nitroprusside

Medication for hypertensive crisis known as a centrally acting vasodilator that causes direct vasodilation of arteries and veins resulting in rapid reduction of blood pressure.

Complications of Nitroprusside

Excessive hypotension and cyanide poisoning/thiocyanate toxicity.

Diuretics

Increase the excretion of sodium and water from the kidney to lower blood pressure.

Types of Diuretics

Thiazide, thiazide-like and potassium-sparing

Sympathetic Nervous System Blockers

Beta-blockers, alpha- and beta-blockers, alpha-adrenergic blockers, alpha1-blockers and alpha2-agonists.

Antihypotensive Agents

Midodrine (generic) and Droxidopa (Northera).

Excessive Hypotension Nursing Actions

Monitor blood pressure and ECG continuously. Keep client supine during administration.