Medications - Antihypertensive-1.doc - 1 Antihypertensive...

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Antihypertensive Medications Classification Examples Action Adverse Effects Nursing Considerations A ACE-I (Angiotensin- Converting Enzyme Inhibitors) Benazepril (Lotensin) Captopril (Capoten) Enalapril (Vasotec, Vasotec IV) Lisinopril (Prinivil, Zestril) Ramipril (Altace) Trandolapril (Mavik) Fosinopril (Monopril) Quinapril (Accupril) Moexipril (Univasc) Perindopril (Aceon) Inhibits the synthesis of angiotensin II decreases blood pressure & increases urinary output (UOP)—via blockage of aldosterone release. Used in treatment of hypertension, heart failure, and myocardial infarction -Side effect (most common--- 10% of patients): persistent cough (acts on vasodilator bradykinin, causing a chronic, dry or “tickling” non- productive cough. -Side effect: postural hypotension -Life threatening side effect: angioedema (hypersensitivity reaction featuring noninflammatory swelling of the skin, mucus membranes & other organs; laryngeal swelling can lead to death; more common in African Americans; usually occurs in the first few days; less than 0.1% of patients----risk is higher when drug administration is continued despite the development of mouth ulcers or skin rash. Monitor BP, UOP, K+ levels. May cause hyperkalemia. Should not be used in pregnancy (high risk of renal developmental anomalies). A ARB (Angiotensin II Receptor Blockers) Candesartan (Atacand) Losartan (Cozaar) Valsartan (Diovan) Irbesartan (Avapro) Olmesartan (Benicar) Telmisartan (Micardis) Eprosartan (Teveten) Tasosartan (Verdia) Azilsartan (Edarbi) Blocks receptors for angiotensin II in arteriolar smooth muscle & the adrenal gland decreases blood pressure & increases UOP--- via blockage of aldosterone. -Side effects similar to ACE- Is. Persistent cough appears to not be as common. -Side effect: postural hypotension -Should not be given in pregnancy. -Also, risk for angioedema. Monitor BP. UOP, K+ levels. May cause hyperkalemia. A Alpha 2-Adrenergic Agonists (Centrally Acting) Clonidine (Catapres) Methyldopa (Aldomet) Guanfacine (Intuniv, Tenex) Enters the brain and inhibits sympathetic outflow by activating receptors in the vasomotor center leading to decreased systemic blood pressure; Lowers peripheral vascular resistance, heart rate, and cardiac output -Common side effects: sedation & dry mouth. -Other side effects: bradycardia, orthostatic hypotension, sleep disturbances, male sexual dysfunction.
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