HTN Meds
What are the classes of drugs that treat HTN?
Diuretics
ACE Inhibitors (angiotensin-converting enzyme inhibitors)
ARBS (angiotensin receptor blockers)
Adrenergic Drugs
CCBS (Calcium Channel Blockers)
Vasodilators
Direct Renin Inhibitors
How do each of the classes decrease BP?
Diuretics
o “Water Pill” 1st choice of new diagnosis of HTN
ACE Inhibitors
o Slows down aldosterone
ARBS
o Works by blocking angiotensin II & stop vasoconstriction & aldosterone
Adrenergic Drugs
o Decrease nor-epinephrine – inhibits sympathetic response Vasoconstriction, HR,
Contractibility = decrease BP
CCBS
o Relax muscles/ allows vessels to dilate
Vasodilators
o Relaxes and vasodilates to decrease BP
Direct Renin Inhibitors
What is the black box warning for ACE inhibitors?
Fetal Toxicity
What electrolyte do you have to monitor with ACE inhibitors?
Potassium levels (5mEq/ml)
What are the 4 main adverse effects associated with ACE inhibitors?
Dry nonproductive cough
Hyperkalemia
1st dose hypotension
Angioedema
What happens when you take ACE inhibitors with NSAIDS?
May lead to liver or renal toxicity
risk of: Hyperkalemia, hypotension, and renal failure
How would you educate pts about potassium and ACE inhibitors?
, Don’t eat excessive amounts of foods high in potassium (avocado, oranges, bananas, low-fat
milk)
Don’t stop abruptly
Monitor BP with journal @ same time everyday
Be careful when standing up
Do not get pregnant (use birth control)
Why do you have to be concerned with renal stenosis and ARBs?
ARBs can upset the kidneys, especially if the blood vessels to your kidneys are narrowed
What adverse effects do you have if you stop BP meds abruptly?
Rebound Hypertension
What adverse effects can you have with the first dose of HTN medications?
Hypotension (dizzy, faint), syncope, reflex tachycardia
What HTN meds can be given as a patch and how do you educate patients about the patch?
Clonidine (A2 Agonist)
o Keep in place for 1 week (with adhesive patch on)
o Rotate Sites: (chest, back of upper arm)
o Dry, Intact Skin
o NO MRI
What would be a contraindication for giving a Beta blocker for HTN?
Pregnancy, Bradycardia, Respiratory Dz
What adverse effects would you anticipate when giving a Beta blocker for HTN?
Bradycardia or heart block, Mask Hypoglycemia S/S
In What situation is it appropriate to give labetalol?
HTN Crisis, pregnancy HTN
What would be two reasons not to give an ordered BP medication to a pt?
Low Heart Rate (<60)
Low BP (<90/60)
What are 4 Calcium Channel Blockers?
Amlodipine
Verapamil
Diltiazem
Nifedipine
Nicardipine
What is a common adverse effect of Calcium Channel Blockers
What are the classes of drugs that treat HTN?
Diuretics
ACE Inhibitors (angiotensin-converting enzyme inhibitors)
ARBS (angiotensin receptor blockers)
Adrenergic Drugs
CCBS (Calcium Channel Blockers)
Vasodilators
Direct Renin Inhibitors
How do each of the classes decrease BP?
Diuretics
o “Water Pill” 1st choice of new diagnosis of HTN
ACE Inhibitors
o Slows down aldosterone
ARBS
o Works by blocking angiotensin II & stop vasoconstriction & aldosterone
Adrenergic Drugs
o Decrease nor-epinephrine – inhibits sympathetic response Vasoconstriction, HR,
Contractibility = decrease BP
CCBS
o Relax muscles/ allows vessels to dilate
Vasodilators
o Relaxes and vasodilates to decrease BP
Direct Renin Inhibitors
What is the black box warning for ACE inhibitors?
Fetal Toxicity
What electrolyte do you have to monitor with ACE inhibitors?
Potassium levels (5mEq/ml)
What are the 4 main adverse effects associated with ACE inhibitors?
Dry nonproductive cough
Hyperkalemia
1st dose hypotension
Angioedema
What happens when you take ACE inhibitors with NSAIDS?
May lead to liver or renal toxicity
risk of: Hyperkalemia, hypotension, and renal failure
How would you educate pts about potassium and ACE inhibitors?
, Don’t eat excessive amounts of foods high in potassium (avocado, oranges, bananas, low-fat
milk)
Don’t stop abruptly
Monitor BP with journal @ same time everyday
Be careful when standing up
Do not get pregnant (use birth control)
Why do you have to be concerned with renal stenosis and ARBs?
ARBs can upset the kidneys, especially if the blood vessels to your kidneys are narrowed
What adverse effects do you have if you stop BP meds abruptly?
Rebound Hypertension
What adverse effects can you have with the first dose of HTN medications?
Hypotension (dizzy, faint), syncope, reflex tachycardia
What HTN meds can be given as a patch and how do you educate patients about the patch?
Clonidine (A2 Agonist)
o Keep in place for 1 week (with adhesive patch on)
o Rotate Sites: (chest, back of upper arm)
o Dry, Intact Skin
o NO MRI
What would be a contraindication for giving a Beta blocker for HTN?
Pregnancy, Bradycardia, Respiratory Dz
What adverse effects would you anticipate when giving a Beta blocker for HTN?
Bradycardia or heart block, Mask Hypoglycemia S/S
In What situation is it appropriate to give labetalol?
HTN Crisis, pregnancy HTN
What would be two reasons not to give an ordered BP medication to a pt?
Low Heart Rate (<60)
Low BP (<90/60)
What are 4 Calcium Channel Blockers?
Amlodipine
Verapamil
Diltiazem
Nifedipine
Nicardipine
What is a common adverse effect of Calcium Channel Blockers
