Medications affecting Blood Pressure
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| ACE inhibitors (Pg. 249); generic name ending | Prils, ex: Captopril
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| What does ACE inhibitor stand for? | Angiotensin-converting enzyme inhibitor
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| What do ACE inhibitors do? | block conversion of angiotensin I to angiotensin II
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| ACE Inhibitor affects the body how... | vasodilation
excretion of na and water
retention of K by kidneys
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| When to use ACE inhibitors | HTN
Heart failure
MI (decrease mortality)
Diabetic/non-diabetic nephropathy
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| Adverse effects of ACE | Orthostatic HTN
Cough
Hyperkalemia
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| Captopril Side effects: | rash and dysgeusia (altered taste
Neutropenia
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| Pregnancy risk for ACE inhibitors | Category D
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| ARBs (pg. 252); generic name ending | Sartan; ex: Losartan
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| What does ARB stand for? | Angiotensin II Receptor blockers
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| What do ARBs do? | Block action of angiotensin II in body
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| ARBs affect the body how... | Vasodilation
Excretion of sodium and water
Retention of Potassium
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| When to use ARBs | HTN
Heart failure
Stroke Prevention
Delay profession of diabetic nephropathy
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| Major difference between ACE/ARBS | Cough and hyperkalemia and not adverse affects of ARBs
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| Aldosterone Antagonists (AA) (pg. 253)...two meds | eplerenone
spironolactone
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| What do aldosterone antagonists do? | reduce blood volume by blocking aldosterone receptors in kidney which causes excretion of sodium and water
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| When to use aldosterone antagonists? | HTN
Heart failure
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| How to remember aldosterone antagonists? | We will SE you at AA)
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| Side effects of aldosterone antagonists? | hyperkalemia
hyponatremia
Dizzy
Flu-like symptoms
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| Contraindications for aldosterone antagonists? | high K levels
kidney impairment
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| Direct Renin Inhibitors (pg. 254) ...one med | aliskiren
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| How to remember direct renin inhibitors | ren sounds like renin
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| What do direct renin inhibitors do? | inhibit production of angiotensin I (which produces angiotensin II and aldosterone)
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| Calcium channel blockers (pg. 255); generic name endings | Pines (difedipine, amlodipine, felodipine, nicardipine)
but also verapamil and diltazem
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| Actions of Nifedipine on the body | blocks ca channels in blood vessels causing vasodilation
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| Actions of Verapamil and diltiazem | blocks ca channels in blood vessels
Decrease force of heart, decreased heart rate, slow rate of conduction
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| Which calcium channel blockers also help cardiac dysrhythmias | verapamil and diltiazem
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| Alpha Adrenergic Blockers (Sympatholytics) (pg. 259) generic name endings | zosin (prazosin, doxazoin mesylate, terazosin)
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| How to remember alpha adrenergic blockers | sound like dinosaurs, AAB (and also affects bladder)
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| What do alpha adrenergic blockers do? | venous/arterial dilation
smooth muscle relaxation or bladder neck
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| Why would you use alpha adrenergic blockers? | HTN
decrease manifestations of BPH (urgency, frequency and dysuria)
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| Centrally acting alpha2 agonists (pg 260) 3 drugs | clonidine, guanfacine HCl, methyldopa
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| What do centrally acting alpha2 agonists do? | decrease sympathetic outflow = bradycardia and decreased CO
vasodilation (decreased BP)
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| Why would we use centrally acting alpha2 agonists? | HTN
severe cancer pain
investigational use
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| Side effects of centrally acting alpha2 agonists | drowsy/sedation
dry mouth
rebound HTN if abrupt discontinuation
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| Beta adrenergic blockers (Sympatholytics) (pg. 262); generic endings | LOL's
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| Beta1 beta adrenergic blockers | affects ONLY the heart
metoprolol
atenolol
metoprolol succinate
esmolol
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| Beta1/2 beta adrenergic blockers | affecting BOTH heart and lungs
Propranolol
Nadolol
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| What do beta adrenergic blockers do? | decreased HR
decrease myocardial contractility
decreased rate of conduction
vasodilation
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| Why would we use beta adrenergic blockers? | HTN
angina, tachydysrhythmias, HF, MI
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| Which medication is contraindicated for someone with asthma? | Nonselective beta1/2 beta adrenergic blockers
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| Which beta blockers can be given IV? | atenolol, metoprolol, labetol, propranolol
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| Medications for HTN crisis (pg. 265) | Nitroprusside - centrally acting vasodilator
Nitroglycerin - vasodilator
Nicardipine - CCB
Clevidipine - CCB
Enalaprilat - ACE
Esmolol HCL - ACE
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| Purpose of medications for HTN crisis | vasodilate arteries and veins causing rapid reduction of BP
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| Adverse effects of htn medications | cyanide poisoning (HA, drowsy)
Thiocyanate toxicity (delirium, psychosis)
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