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.