-Drugs that influence the contractily of muscular tissue.

-The "squeeze" effect

-Can be positive or negatve

(Positive-squeezes heart/ Negative-squeezes heart not so hard)

-Drugs that influence the HR

-Can be positive or negative

-Drugs that affect the condition velocity of nerve or muscle fibers

-Can be positive or negative

Hypertension Drugs:

Beta Blockers

Prototype: ____

Hypertension Drugs:

Beta Blockers

Prototype: Propranol (Inderal)

Also known as:____

Hypertension Drugs:

Beta Blockers

Prototype: Propranol (Inderal)

___: at the end of each name of drug.

Hypertension Drugs:

Beta Blockers

Prototype: Propranol (Inderal)

Indications (5):

1. Hypertension
2. Anigna
3. Prevent cardiac arrhythmias
4. Migranes
5. Frequently used by anxious lecturers.

Hypertension Drugs:

Beta Blockers

Prototype: Propranol (Inderal)

1. Blocks beta-adrenergic receptors in the nervous system, & blocks beta-receptors of the heart.
2. It does this by inhibiting catecholamine binding @ beta one & beta two receptor sites.
3. This decreases HR, contractility & excitability, which reduces cardiac workload.

Hypertension Drugs:

Beta Blockers

Prototype: Propranol (Inderal)

1. Hypotension
2. Bradycardia
3. Fatigue/ Weakness
4. Syncope
5. GI
6. Decreased libido
7. Pulmonary edema
8. allergic reaction

Hypertension Drugs:

Beta Blockers

Prototype: Propranol (Inderal)

Nursing Implications (3):

1. Inform pt about the drug
2. Daily pulse and BP
3. Tapering

*Stress Test: Hold! (will make symptoms)

-Increases the volume of urine produced

-Increases Na excretion

-Na causes increased intravascular volume & therefore increases BP

-Can have a vasodilating effect.

-Must be very careful in watching lab work- K is also pulled out during excretion-Most pts will have a K supplement prescribed.

-Assess for s&s of dehydration.

-Use cautiously w/ renal pts

Diuretics

"Water pill"

Diuretics

Uses (5):

1. Hypertension
2. HF
3. Pulmonary Edema
4. Cirrhosis
5. Some types of renal disease

Hypertension Drugs:

Diuretics- Thiazides

Prototype:____

Hypertension Drugs:

Diuretics- Thiazides

Prototype: Hydrochlorothiazid (Hydrodiuril) HCTZ

Indications (3):

1. Hypertension
2. HF
3. Liver/Renal disease

Hypertension Drugs:

Diuretics- Thiazides

Prototype: Hydrochlorothiazid (Hydrodiuril) HCTZ

Actions (2):

1. Blocks the Chloride pump in the kidney. (Keeps the Chloride in the kidney to be excreted- Na moves out along w/ the Chloride)
2. Considered to be a mild diuretic.

Hypertension Drugs:

Diuretics- Thiazides

Prototype: Hydrochlorothiazid (Hydrodiuril) HCTZ

Adverse Effects (3):

1. Orthostatic hypotension
2. Hypokalemia
3. Muscle cramps/spasms

Hypertension Drugs:

Diuretics- Thiazides

Prototype: Hydrochlorothiazid (Hydrodiuril) HCTZ

Nursing Implications (4):

1. Teaching
2. Watch labs
3. I&Os (daily weight)
4. Watch for S&S of dehydration & hypotension

Hypertension Drugs:

Diuretic- Loop Diuretics

Prototype: ____

Hypertension Drugs:

Diuretic- Loop Diuretics

Prototype: Furosemide (Lasix)

Indications (4):

1. Much more diuresis than other diuretics- up to 20lbs a day!
2. HF
3. Hypertension
4. Renal disease

Hypertension Drugs:

Diuretic- Loop Diuretics

Prototype: Furosemide (Lasix)

Actions (2):

1. Work in blocking Chloride pump in the loop of Henle, & bring Na along w/ it.
2. The loop of Henle is where 30% of all filtered Na is reabsorbed.

Hypertension Drugs:

Diuretic- Loop Diuretics

Prototype: Furosemide (Lasix)

Adverse Effects (6):

1. Hypokalemia
2. Hypocalcemia
3. Alkalosis
4. Bladder spasms
5. Hypotension
6. Constipation

Hypertension Drugs:

Diuretic- Loop Diuretics

Prototype: Furosemide (Lasix)

Nursing Implications (6):

1. Watch labs
2. Make sure MD is prescribing K supplements./ Encourage K rich foods
3. Watch for s&s of dehydration & hypotension
4. BCS? Foley?
5. Consider changing BID.
6. I&Os (Daily weight)

Hypertension Drugs:

Diuretic- Potassium-Sparing Diuretics

Prototype:____

Hypertension Drugs:

Diuretic- Potassium-Sparing Diuretics

Prototype: Spironolactone (Aldactone)

Indications (4):

1. Hypertension
2. HF
3. Cirrhosis
4. Used when pts are susceptible to hypokalemia.

Hypertension Drugs:

Diuretic- Potassium-Sparing Diuretics

 Prototype: Spironolactone (Aldactone)

1. Blocks K secretion by blocking the effects of aldosterone in the kidneys, while allowing Na secretion.

Hypertension Drugs:

Diuretic- Potassium-Sparing Diuretics

 Prototype: Spironolactone (Aldactone)

Adverse Effects (1):

1. Hyperkalemia

Hypertension Drugs:

Diuretic- Potassium-Sparing Diuretics

 Prototype: Spironolactone (Aldactone)

Nursing Implications (3):

1. Monitors K levels
2. Watch for s&s of hyperkalemia (LOC changes, cramps, heart arrhythmias)
3. Avoid foods high in K

Diuretics

Advantages: Inexpensive

Disadvantages (3):

1. Risk for electrolyte imbalances
2. Best way to measure effectiveness is loss of wt (fluid)
3. A decrease in edema is okay, but's variable to the assessor, & can fluctuate thru out the day due to elevation of extremities (or lack thereof).

Hypertension Drugs:

Ace Inhibitors

Prototype: ___

Hypertension Drugs:

Ace Inhibitors

Prototype: Captopril (Capoten)

Also known as: ____

Hypertension Drugs:

Ace Inhibitors

Prototype: Captopril (Capoten)

___: @ end of drug name

Hypertension Drugs:

Ace Inhibitors

Prototype: Captopril (Capoten)

Indications (3):

1. Hypertension
2. HF
3. Left ventricular problems after MI

Hypertension Drugs:

Ace Inhibitors

Prototype: Captopril (Capoten)

Action (2):

1. Blocks the conversion of angiotensin I to angiotensin II by inhibiting the release of renin.
2. The renin-angiotensin system is compensatory system to ensure that enough blood gets to the kidneys.

Hypertension Drugs:

Ace Inhibitors

Prototype: Captopril (Capoten)

Adverse Effects (4):

1. Tachycardia
2. MI
3. Bone marrow suppression
4. "Cardiac Cough"

Hypertension Drugs:

Ace Inhibitors

Prototype: Captopril (Capoten)

Nursing Implications (3):

1. Teaching
2. Baseline tests
3. Caution in PG women

Hypertension Drugs:

Calcium Channel Blockers

Prototype: ___

Hypertension Drugs:

Calcium Channel Blockers

Prototype: Diltiazem (Cardizem)

Indications (2):

1. Hypertension
2. Angina

Hypertension Drugs:

Calcium Channel Blockers

Prototype: Diltiazem (Cardizem)

Actions (2):

1. Inhibits Ca mvmt across the cell membranes of the heart & arterial muscle cells. This inhibits the action potential & muscle cell contraction. 
2. Results: Lowers contractiltiy, slows cardiac impulses (HR), relaxes & dilates arteries- Causes fall in BP & decrease in venous return.

Hypertension Drugs:

Calcium Channel Blockers

Prototype: Diltiazem (Cardizem)

Adverse Effects (6):

1. Hypotension
2. Bradycardia
3. Heart arrhytmias
4. CNS effects
5. Liver damage
6. Flushing of skin

Hypertension Drugs:

Calcium Channel Blockers

Prototype: Diltiazem (Cardizem)

Nursing Implications (4):

1. Care w/ crushing
2. s&s of hypotension
3. Avoid grapefruit juice (Increases effects)
4. Instruct to take daily-Okay to take late-Better than skipping a dose

-Decreases vasodilation

-Decreases prostaglandin synthesis (affects kidneys)

-Give cautiously in renal pts