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HTN meds
Classification | Med | Use of med | SE | Important |
---|---|---|---|---|
Avoid K+ ACE inhibitors | âPrilâ drugs | Prevent conversion of angiotensin 1 to angiotensin ll. Prevents vasoconstriction | Dry persistent cough Changes in taste Dizziness Fatigue | NSAIDs/aspirin decrease effectiveness African Americans do not respond well Do not use wit k+ sparing diuretic Avoid k+ substitutes Rebound HTN in non compliant |
ARBS | âSartanâ | Blocks aldosterone Blocks angiotensin ll from AT1 receptor | Dizziness Fatigue Insomnia *no dry cough | Less effective in African Americans Watch renal function |
*P Beta blockers | âLolâ | Inhibits SNS Vasodilator | Decrease BP Insomnia Depression Nightmares Fatigue sexual dysfunction | Do not use in pts with asthma/COPD Take apical pulse before giving Rebound HTN if not compliant DM= masks hypoglycemia |
Calcium channel blockers | Diltiazem Verapamil Amlodipine Nifedipine | Inhibits Ca across cell membrane resulting in vasodilation Decrease HR | Flush Dizziness Ankle edema Bradycardia | May work better for African Americans Do NOT ingest grapefruit Watch for bradycardia |
Increase K+ Diuretic (loop) | Furosemide Bumetanide Torsemide | Promotes NaCl & H2O excretion | Orthostatic hypotension Electrolyte abnormalities | Usually used first Not for pts with renal issues Watch lithium levels Increase potassium intake Photosensitive |
Increase K+ Diuretic (thiazides) | Metolazone Hydrochlorothiazide | Promotes NaCl & H2O excretion | Orthostatic hypotension Hypokalemia | NSAIDs can decrease effectiveness Not for pts with renal issues Watch lithium levels Increase potassium intake Photosensitive |
Potassium sparing diuretic | Spironolactone Trimaterene | Reduces excretion of K+ | Not for renal failure pts Avoid k+ Use cautiously with ACE/ ARBS | |
*P Cardiac glycoside | Digoxin | Makes heart beat stronger | Dig toxicity- Anorexia N/V Diarrhea Blurred vision Decreased HR Confusion | Take pulse before giving If less than 60 hold and call DR Monitor K+ Dig toxicity use digibond |
Entresto | Hypotension Hyperkalemia Cough Dizziness | Canât take with ACE inhibitors Must wait 36 hrs | ||
Vasodilator | Nitrates Sodium nitro Nesiritide | |||
Relaxing smooth muscle of blood vessels | Tachycardia Palpitations Edema Dizziness Restless | Pts shouldnât take nitroglycerin with viagara |