Mechanism of action: inhibitors block the conversion of angiotensin I to the vasoconstrictor angiotensin II. . ACE inhibitors also increase plasma renin levels and decrease aldosterone levels in blood stream. Adverse effects/food interactions: hypotension, taste disturbance, erectile dysfunction, impaired renal function, chest pain Nursing implications: take BP before admission, report to HCP of any swelling in lips, face or tounge. If patient has trouble swallowing pills, it comes in oral suspension. Classification: antihypertensive/ angiotensin II receptor antagonists Prototype: losartan (Cozaar) therapeutic effect: Lowering of BP in hypertensive patients. Decreased progression of diabetic nephropathy. Decreased incidence of stroke in patients with hypertension and left ventricular hypertrophy (effect may be less in black patients). Mechanism of action: Blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II at various receptor sites, including vascular smooth muscle and the adrenal glands. Adverse effect/food interaction: renal failure, hyperkalemia, weight gain, drug induced hepatitis Nursing implications: don’t not use salt substitutes. Report to HCP immediately if: swelling of hands or feet, dry cough, metallic taste that produces anorexia. Women should use contraception. Take BP before of administration. Classification: diuretic/ loop diuretic Prototype: furosemide (Lasix) Therapeutic effects: Diuresis and subsequent mobilization of excess fluid (edema, pleural effusions). Decreased BP. Mechanism of effects: Inhibits the reabsorption of sodium and chloride from the loop of Henle and distal renal tubule. Increases renal excretion of water, sodium, chloride, magnesium, potassium, and calcium. Effectiveness persists in impaired renal function.
Adverse effect/food interaction: excessive urination, photosensitivity, dehydration, muscle cramps, paresthesia Nursing implications: always check BP and potassium levels before administering. (normal range of K 3.5-5) give last dose no later than 5 pm to minimize disruption of sleep cycle. Tablets may be crushed if patient has difficulty swallowing. Change position slowly to minimize effects of orthostatic hypertension. Use sunscreen. Report any allergic reactions to sulfonamides prior to therapy Classification: antianginals, antihypertensives Prototype
- Fall '17
- Angiotensin II receptor antagonist, Adverse effect/food interaction