VERSION)
(Everything you must know — short, clean, and high-yield)
1. Physiologic Risk Factors for Hypertension
Too much fluid (↑ volume)
Vasoconstriction (↑ resistance)
High saturated fat & simple carbohydrate intake
Alcohol ↑ renin → ↑ BP
Obesity
2. Non-Pharmacologic BP Management
Stress reduction
Exercise
Salt restriction
Decrease alcohol
Smoking cessation
3. Major Antihypertensive Drug Classes
Diuretics
Beta-blockers (-olol)
Alpha-blockers
Calcium channel blockers (CCB) (-pine)
ACE inhibitors (-pril)
ARBs (-sartan)
4. Beta-Blockers (-olol)
Examples: Metoprolol (selective β1), Propranolol(not good for asthma COPD
patient) (non-selective β1 & β2)
Action
, Blocks adrenergic effects
↓ HR
↓ BP
Uses
Hypertension
Dysrhythmias
Angina
Good in African Americans when combined with diuretic
Avoid
Propranolol in asthma/COPD (blocks β2) (metoprolol is the option)
5. Alpha-Blockers (Prazosin) high blood pressure and BPH and we don’t
take it with tamsulosin
Action
Blocks alpha receptors → vasodilation → ↓ BP
Uses
Hypertension
Heart failure
BPH
Good monotherapy for African Americans
Side Effects
Dizziness, headache
Peripheral edema, weight gain
Urinary incontinence
Elevated liver enzyme
Orthostatic hypotension
Erectile dysfunction
Safer for asthma and diabetics
6. Calcium Channel Blockers (CCB) (-pine)
,Examples: Amlodipine, Verapamil, Diltiazem
Action
Blocks calcium movement in/out of cells → vasodilation & ↓ HR
Uses
HTN
Angina
Dysrhythmias
Peripheral vascular disease
Effective as monotherapy in African Americans
Side Effects
Flushing
Headache
Peripheral edema
Hypotension
Bradycardia
Erectal dysfunction
Contraindication:
Decrease blood pressure
Interaction= OTC cold medication
alcohol, high blood pressure bindings drug, other drug lower blood pressure
7. ACE Inhibitors (-pril) angiotensin 2 = hypothalamus => thirst
Aldosterone= hypokalemia, hypernatremia, and extra water
Ace, pril= don’t allowed angiotensin 2 happens.
Example: Lisinopril
Action
Blocks angiotensin II formation → vasodilation
Blocks aldosterone → releases Na+ & water, retains K+
Uses
Hypertension
, Heart failure
Side Effects (VERY IMPORTANT)
Dry, constant nonproductive cough (classic!)
Hyperkalemia
Orthostatic hypotension
Angioedema
Nephrotoxic
Contraindications
Pregnancy
Potassium-sparing diuretics (spironolactone)
Salt substitutes (contain K+)
8. ARBs (-sartan, -tan)
Example: Losartan
Action
Blocks angiotensin II from binding to receptors
No vasoconstriction
Releases Na+ & water
Retains K+
Uses
Hypertension
Heart failure
Side Effects
Does NOT cause ACE inhibitor cough
Dizziness, fatigue
Hyperkalemia
Renal dysfunction
9. Nursing Assessment for Antihypertensives
Vital signs (especially HR for beta-blo ckers & CCBs) <60