Wk 3 notes 2 - DRUG AFFECTING THE CARDIOVASCULAR SYSTEM...

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DRUG AFFECTING THE CARDIOVASCULAR SYSTEM DRUGS AFFECTING THE CARDIOVASCULAR SYSTEM : Treatment of Hypertension The treatment of essential hypertension is usually an endeavor that will continue for the remainder of the patient's life. Selection of initial therapy should be geared at controlling blood pressure with minimal side effects in order to enhance patient compliance. List of Available Thiazide Diuretics in the Treatment of Hypertension - hydrochlorothiazide (HCTZ) (HydroDiuril) - chlorothiazide (Diuril) - chlorthalidone (Hygroton) - benzthiazide (Exna) - bendroflumethiazide (Naturetin) - methylclothiazide (Enduron) - indapamide (Lozol) - metolazone (Zaroxolyn)(Mykrox) - polythiazide (Renese) - triclomethiazide (Metahydrin) (Diurese) Pharmacodynamics of the Thiazide Diuretics Somewhat unclear as to the precise mechanism of action, the thiazide diuretics act in the distal renal tubules to block the reabsorption of the filtered load of NaCl from the nephron back into the blood. In this way, the thiazides are said to have a natriuretic effect; they promote the renal excretion of sodium (and consequently water) from the body. [Note: Where sodium goes - so goes the water.] By reducing the amount of water in the body, the amount of water in the blood (i.e., blood volume) is also reduced. This results in decreased stroke volume and decreased cardiac output. The overall result of a reduction in blood volume, stroke volume, and cardiac output is that blood pressure is reduced. Pharmacokinetics of the Thiazide Diuretics The thiazides are administered orally and are well absorbed by this route. Many of the thiazides are not metabolized and are excreted primarily by the kidney by way of the organic acid secretory ports of the renal tubule, competing with the body's normal organic acid waste products. They are water-soluble drugs. Some of the thiazides are metabolized by the liver and their metabolites are also excreted in the urine. Advantages of Using Thiazide Diuretics in the Treatment of Hypertension 1
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DRUG AFFECTING THE CARDIOVASCULAR SYSTEM - Administered orally; this is an advantage in any pharmacotherapeutic plan that will be long-term, as is the case with hypertension. - Once daily or BID dosing regimen; this is very important in the long-term management of any condition. The fewer times a day a patient is required to take medication, the more likely he is to be compliant. - Inexpensive; again, very important in any long-term therapy plan, especially one that is likely to be for a lifetime. - Significant reduction in blood volume; reduction of blood volume is the main mechanism by which thiazides reduce blood pressure. Although the reduction in pressure is limited to a certain extent, they will still deplete the blood volume considerably. - Very effective in African-Americans; although anyone can be treated with diuretics,
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This note was uploaded on 05/19/2011 for the course NURSING 517/617 taught by Professor Lipstate during the Spring '11 term at University of Louisiana at Lafayette.

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Wk 3 notes 2 - DRUG AFFECTING THE CARDIOVASCULAR SYSTEM...

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