Summary NURS 172 Blood Pressure Medications

BP medications
Classification Sympatholytics
Centrally acting alpha2
Sub- ACE ARB Aldosterone antagonists Direct renin inhibitors Calcium channel blockers Alpha adrenergic blockers Beta adrenergic blockers
agonists
classifications
Action Block the formation of Block the action of angiotensin Reduce blood volume by Bind with renin to inhibit Lead to vasodilation of Act within CNS to decrease Select alpha1 blockade Beta1 (cardioselective)
angiotensin II II blocking aldosterone receptors production of angiotensin I vascular smooth muscle sympathetic outflow  Venous and arterial dilation Beta1 and Beta2 (nonselect
 Vasodilation  Vasodilation in the kidneys decreasing angiotensin II and (arteries less on veins. decreasing stimulation of the  Smooth muscle relaxation of  Decreased HR
 Kidneys excrete sodium  Kidneys excrete sodium  Kidneys excrete sodium aldosterone Verapamil and diltiazem work adrenergic receptors the prostatic capsule and  Decreased myocardia
and water, retain and water and water, retain in the myocardium, SA node,  In the myocardium it bladder neck contraction (decrease
potassium potassium and AV node decreasing force results in bradycardia and  Decreased rate of AV
of contraction, HR, and decreased cardiac output conduction
slowing rate of conduction  In the peripheral Alpha and beta blockers
through the AV node vasculature causes  Alpha adds vasodilatio
vasodilation and lower BP
Used to treat HTN, HF, MI, neuropathy HTN, HF, stroke prevention, HTN, HF HTN Angina, HTN Primary HTN, HTN, benign prostatic hyperplasia Primary HTN, angina, HF, M
diabetic neuropathy Verapamil and diltiazem also (BPH) tachydysrhythmias
Used when patient is unable cardiac dysrhythmias
to tolerate an ACE
Common Meds Captopril Losartan Spironolactone Aliskiren Nifedipine Clonidine Prazosin Beta1 (cardioselective): me
-prils -sartans Eplerenone -pines -osins Beta1 and Beta2 (nonselect
Verapamil propranolol
Diltiazem Alpha and beta blockers:
carvedilol

Complications  Cough, rash, dysgeusia  Angioedema  Hyperkalemia  Angioedema, rash, cough Nifedipine:  Drowsiness, sedation  1st dose orthostatic Beta1 blockade:
 Hyperkalemia  Hypotension  Flu-like symptoms  Hyperkalemia  Reflex tachycardia  Dry mouth hypotension  Bradycardia
 Angioedema  Dizziness/  Gynecomastia  Diarrhea  Acute toxicity  Rebound HTN  Decreased cardiac out
 Neutropenia (rare) lightheadedness  Dizziness/ fatigue  Hypotension  Orthostatic hypotension  AV block
 1st dose orthostatic and peripheral edema  Orthostatic hypotensi
hypotension  Rebound myocardium
excitation

Beta2 blockade
Verapamil and diltiazem:  Bronchoconstriction
 Orthostatic hypotension  Glycogenolysis (the
and peripheral edema breakdown of glycoge
 Suppression of cardiac inhibited
function, dysrhythmias,
acute toxicity


Nursing  Notify provider to d/c  Change position slowly  Report enlargement and  Notify provider of Nifedipine:  Drowsiness, sedation, and  Monitor BP, start with a low Beta1 blockade:
Considerations med  Avoid activities that tenderness of male breast diarrhea monitor  Too large a dose affects dry mouth tend to be self- dose usually taken at night  Monitor VS, hold HR <
 Monitor potassium levels require alertness until tissue heart. Monitor VS. limiting  Use with caution for H
(3.5-5 mEq/L) aware of effects  Monitor BP, weight,  Do not discontinue monitor for signs of w
 Monitor WBC edema without contacting the HF
 Monitor for S&S, notify provider, d/c over 2-4  Baseline ECG
provider, d/c med., days  Myocardium becomes
treatment SQ epinephrine sensitized to catechola
 Monitor BP, start with a with long term use, do
low dose stop abruptly, d/c ove
weeks
Verapamil and diltiazem: Beta2 blockade
 Monitor VS, ECG  Avoid in asthmatics
 Diabetic mellitus patie
on the breakdown of g
into glucose to manag
blood sugars. Monitor
glucose levels.