Campbell’s CV Pharmacology for Nursing: anti-hypertensives, HF & anti-anginals

We use cookies to give you the best experience possible. By continuing we’ll assume you’re on board with our cookie policy
lisinopril
ramipril
enalapril

End in -pril

3 Examples of angiotensin converting enzyme inhibitors (ACE-I)

Causes VASODILATION by inhibiting angiotensin converting enzyme (ACE) which inhibits production of aldosterone & angiotensin II (a potent vasoconstrictor).
Prevents breakdown of bradykinin (can cause adverse effect of cough)
Action of ACE-I

Hyperkalemia
ACE-I decrease aldosterone, leading to Na+ and water loss & K+ retention
Potential electrolyte abnormality caused by ACE-I and rationale

Hypotension
Dry Cough
Angioedema
Hyperkalemia
Renal failure
Adverse effects of ACE inhibitors

BP
BUN/creatinine
potassium
3 Key nursing assessments (VS & labs) prior to administering ACE-I

Hypertension
Heart Failure
Indications for ACE-I

losartan
valsartan

End in -sartan

2 Examples of angiotensin receptor blockers (ARBs)

Used when ACE-I are not tolerated (i.e. excessive dry cough)
HTN
Heart Failure
Rationale & Indications for ARBs

BP
BUN/creatinine
potassium
Key nursing assessments (VS & labs) prior to administering ARB (same as ACE-I)

Hypotension
Angioedema
Hyperkalemia
Renal failure
DOES NOT CAUSE COUGH
Adverse effects of ARBs
Hint – similar to ACE-I

Selective beta-block inhibit beta-1 receptors the heart only (decrease HR & contractility).

Nonselective beta-blockers inhibit beta-1 receptors in heart (decreases HR and contractility) and beta-2 receptors in the lung (bronchoconstriction).

Therefore, nonselective beta blockers are contraindicated for patients with asthma.

Difference between selective and nonselective beta blockers and precaution with lung disease

Decreases BP & HR

Reduce O2 demand in heart (prevent chest pain)

Slow progression of heart failure

Decreases AV node conduction (slows rate of A fib)

Action of beta-blockers

Hypertension
Coronary artery disease (CAD)
Heart failure
Rapid atrial fibrillation
4 Indications for beta-blockers

metoprolol
atenolol

End in -olol

Examples of selective beta-blockers

propranolol (Inderal)

End in -olol

Example of nonselective beta-blocker

carvedilol
labetalol

End in -olol

2 Examples of nonselective beta/alpha-I blocker

Vasodilation
Action of alpha-I blockage

Bradycardia
Hypotension
CHF
Bronchospasm (nonselective)
Potential to mask signs of hypoglycemia
5 adverse effects of beta-blockers

Blood pressure
Heart rate
2 key nursing assessments prior to administering beta-blocker

HR<50 Systolic BP<90 2nd-3rd degree AV block Volume overload SEVERE asthma or COPD
5 Contraindications for beta-blockers

DHPs work primarily on vascular smooth muscle
Lowers BP by VASODILATION
Hint : D for dilator (Dihydropyridine)

Non-DHPs work primarily in the heart
Slows HR (Class IV anti arrhythmic), plus vasodilation
HINT: Non-D – causes you Not – Die)

Types of Calcium Channel Blockers: Action of dihydropyridines (DHPs) versus non-dihydropyridines (non-DHPs).

Hints: Non-D vs D

amlodipine
nifedipine
nicardipine

End in -dipine

3 Examples of dihydropyridine calcium-channel blocker

Think D for Dilator

verapamil
diltiazem
2 Examples of Non-dihydropyridines calcium-channel blockers (class IV anti arrhythmic)

Think Non-D (Not die – anti-aarhythmic)

Hypertension
Angina
Slow rate of atrial fibrillation (Non-DHPs only)
3 Indications for calcium channel blocker (CCBs)

Hypotension
Bradycardia (Non-DHPs only)
Peripheral edema
Adverse effects of calcium channel blockers (CCBs)

Blood pressure
Heart rate (non-DHPs only)
Key vital sign assessment prior to administering CCBs

clonidine
Example of centrally acting alpha agonist

Inhibit sympathetic output from the brain, blocking the release of norepineprine and causing peripheral VASODILATION
Action centrally acting alpha agonist agonists

Hypotension
Bradycardia
Dry mouth
Sedation
Adverse effects of clonidine

Peripheral and coronary vasodilation
Action of nitroglycerine (NTG)

Relief of chest Pain
Decrease BP
Reduce Preload for CHF
3 Indications for NTG

Hypotension
Reflex tachycardia
Hypotension
3 Adverse effects of nitrates

Change position gradually

Headache is a common side effect initially that should decrease over time

Angina: Sit down & take NTG SL immediately. May repeat every 5minutes till relief obtained. Call doctor or go to ER if no relief after 3 tablets.

Cannot take with medications for erectile dysfunction (sildenafil, tadalafil, vardenafil)- can cause fatal hypotension

Patient teaching for NTG

Ranolazine
Medication use to treat angina that has not effect on BP or HR

Beta-blockers
Calcium channel blocker (non-dihydropyradine)
Centrally acting apha agonist (clonidine)
3 drug Anti-HTN classes that lower heart rate

Positive inotrope (increased contractility)
Negative chronotrope (decreased HR)
2 actions of digoxin

Heart failure
Rapid atrial fibrillation
2 indications for digoxin

Bradycardia
Anorexia, N&V
Visual disturbances (halo
3 Symptoms of digoxin toxicity

Heart rate (hold dose for HR < 60) Digoxin level (therapuetic level 0.5-2.0 ng/mL) Potassium (hypokalemia cause dig toxicity)
3 Nursing assessments prior to administering digoxin

We use cookies to give you the best experience possible. By continuing we’ll assume you’re on board with our cookie policy analgesic compounds with pain-blocking properties, capable of producing analgesia anti-inflammatory agents drugs that block the effects of the inflammatory …

We use cookies to give you the best experience possible. By continuing we’ll assume you’re on board with our cookie policy Two groups of drugs that affect the sympathetic nervous system: The adrenergic agonists (sympathomimetics or adrenomimetics) and the adrenergic …

We use cookies to give you the best experience possible. By continuing we’ll assume you’re on board with our cookie policy What ate four types of RAAS supressants that support the treatmrnt of hypertension? Ace inhibitors Arbs Aldosterone antagonists Direct …

We use cookies to give you the best experience possible. By continuing we’ll assume you’re on board with our cookie policy 26/08/2013 Learning Objectives: After completing this chapter you should able to: •Name categories of cardiovascular drugs •Describe the therapeutics …

We use cookies to give you the best experience possible. By continuing we’ll assume you’re on board with our cookie policy Give 4 prototypes from the Category Penicillin and their actions 1. Penicillin G- for STREP narrow spectrum 2. Ampicillin, …

We use cookies to give you the best experience possible. By continuing we’ll assume you’re on board with our cookie policy -phrine Adrenergic agent / sympathomimetic -olol beta-adrenergic blocker HTN WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC …

David from Healtheappointments:

Hi there, would you like to get such a paper? How about receiving a customized one? Check it out https://goo.gl/chNgQy