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ANTIHYPERTENSIVES TO FOCUS ON FOR THE NSG 345 EXAM
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ANTIHYPERTENSIVES TO FOCUS ON FORTHE NSG 345 EXAM
Alpha Blockers - ANSWER Common Meds: doxazosin, mesylate, prazosin,
hydrochloride
Indication: Vasodiolate, decrease BP, and help maintain renal blood flow rate
Side effects: cause sodium and water retention with edema. orthostatic hypotension
(dizziness, faintness, lightheadedness, and increased heart rate, which may occur
with the first dose), nausea, headache, drowsiness, nasal congestion caused by
vasodilation, edema, and weight gain.
Patient teaching: continue to monitor vital signs, monitor fluid intake and output,
don't stop drop abruptly because it can cause rebound hypertension, change
position slowly, and decrease salt intake.
Alpha-2 Receptor Agonists - ANSWER common meds: clonidine, guanfacine
indication: Decrease sympathetic response to peripheral vessels. Lowers peripheral
resistance--decreases CO, renin release, nor/epinephrine
Side effects: drowsiness, dry mouth, dizziness, and slow heart rate (bradycardia).
Peripheral edema from sodium and water retention.
Alpha-1 and Beta-1 Adrenergic Blockers - ANSWER Common meds: labetalol
hydrochloride
Indication: Blocking the alpha1 receptor causes vasodilation, which decreases
resistance to blood flow. The effect on the alpha receptor is stronger than the effect
on the beta receptor; therefore BP is lowered, and the pulse rate is moderately
decreased
Side effects: orthostatic hypotension, dizziness, paresthesia, nasal congestion,
nausea, and fatigue. Large doses of labetalol may cause atrioventricular (AV) heart
block.
, Contraindication: patient who has asthma should not take large doses of Labetalol.
Patient teaching: take meds at the same time with food, don't stop meds abruptly
because it can worsen chest pain and trigger a heart attack, Advise patients that
dizziness is the most common adverse reaction and tends to occur in the early
stages of treatment in patients taking diuretics, and with higher dosages.
- Inform patients that dizziness can be minimized by rising slowly and avoiding
sudden position changes.
Warn patients that occasional, harmless scalp tingling may occur, especially when
therapy begins.
Nursing Considerations: continue to monitor vital signs (BP), and keep track of
glucose levels because beta-blockers may mask certain signs and symptoms of
hypoglycemia
Beta Blockers - ANSWER Common meds: propranolol, Sotalol (nonselective)
Common Meds: atenolol, metoprolol, carvedilol,
nebivolol (selective)
Indication: To control hypertension, acute myocardial infarction, angina, and HF
Mechanism of Action: Promotes blood pressure reduction via a beta1-blocking
effect.
Side effects: Dizziness, insomnia, depression, fatigue, nightmares, nausea,
vomiting, diarrhea
Adverse: heart block, bronchospasms, bradycardia, agranulocytosis, heart failure,
hypotension
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