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- These drugs affect both the blood pressure and the rhythm of the heart. Monitor patient blood
pressure. *Orthostatic hypotension is a common side effect*.
1) Betablockers
2) Alpha 1 Blockers
3) Calcium Channel blockers
4) ACE Inhibitors
5) ARB Inhibitors
6) Diuretics
Betablockers
- Usually end in *-olol*.
Propranolol (Inderal)
Atenolol (Tenormin)
Metoprolol (Lopressor)
What additional effects of betablockers should the nurse monitor?
- The nurse should monitor for broncho constriction and bronchospasms due to beta-2 adrenergic
blocking mechanisms.
In what population should betablockers be used cautiously in?
- Betablockers should be used cautiously in patients who suffer from asthma.
Beta blockers can mask tachycardia in patients suffering from *hypovolemia* and hypoglycemic
symptoms seen in diabetic patients.
What affects do betablockers cause?
- Therapeutic effects include decreasing blood pressure and heart rate.
Alpha 1 blocker - Clonidine (Catapres)
,What affects do alpha 1 blockers cause?
- They cause systemic vasodilation by directly acting on smooth muscle of arteries.
What adverse effects can alpha 1 blockers cause? - Hypotension, dizziness, sedation.
In what form are alpha 1 blockers usually administered? - Alpha 1 blockers are generally administered as
a patch and are changed once a week.
Calcium Channel Blockers
- Verapamil (Calan)
Dilitiazem (Cardizem)
Amlodipine (Norvasc)
Nifedipine (Procardia)
How do calcium channel blockers work?
- They block the influx of calcium into myocardium resulting in a decrease in contractility. It helps keep
vasculature relaxed and decreases SA and AV node conduction.
What is a common adverse effect caused by verapamil (Calan)?
- A common adverse effect is *constipation*.
What should the nurse monitor in a patient receiving calcium channel blockers?
- The nurse should monitor for edema and hypotension.
ACE Inhibitors
- Usually end in *-pril*.
Enalapril (Vasotec)
Lisinopril (Zestril)
Captopril (Capoten)
How do ACE-Is work?
, - They block angiotensin converting enzymes in the renin-angiotensin loop resulting in decreased blood
pressure which decreases workload on the heart.
What are adverse effects of ACE Inhibitors?
- Adverse effects include hypotension, *dry cough*, and *angioedema*.
What should the nurse monitor for in patients receiving ACE Inhibitors?
- The nurse should monitor the patient's renal function.
Angioedema
- A hypersensitivity reaction of the dermis, mucosa, and submucosa tissues resulting in life threatening
airway obstruction.
Epinephrine is treatment of choice.
ARB Inhibitor - Usually end in *-artan*.
Losartan (Cozaar)
Valsartan (Diovan)
Irbesartan (Avapro)
How do ARB Inhibitors work?
- These work by blocking angiotensin II receptors in the angiotensin loop.
What should the nurse monitor in a patient receiving ARB Inhibitors?
- The nurse should monitor *potassium levels* and renal function.
What adverse effect may occur from ARB Inhibitors?
- Angioedema can occur.
Diuretics
- These are used for both antihypertensive effects and to control edema.
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