VASODILATORS Most of the vasodilators are reserved for use in severe

Vasodilators most of the vasodilators are reserved

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VASODILATORSMost of the vasodilators are reserved for use in severe hypertension, malignant hypertension, or hypertensive emergenciesDiazoxide (Hyperstat): IV for hospitalized patients with severe hypertension; increases blood glucose levelsHydralazine (Apresoline): Maintains increased renal blood flowMinoxidil (Loniten): Used only for severe and unresponsive hypertensionNitroprusside (Nitropress): Used for hypertensive crisis; maintain hypertension during surgery
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Copyright © 2017 Wolters Kluwer • All Rights ReservedVASODILATORS (CONT.) ActionsActs directly on vascular smooth muscle to cause muscle relaxation, leading to vasodilatation, and drop in blood pressureIndicationsSevere hypertensionPharmacokineticsRapidly absorbed and widely distributed, metabolized in the liver, and primarily excreted in the urineContraindicationsAllergy, pregnancy, lactation, cerebral insufficiency
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Copyright © 2017 Wolters Kluwer • All Rights ReservedVASODILATORS (CONT.) CautionPeripheral vascular disease, CAD, CHF, or tachycardiaAdverse Effects Related to changes in the blood pressureGI upsetCyanide ToxicityDrug-to-Drug InteractionsBased on individual drug
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Copyright © 2017 Wolters Kluwer • All Rights ReservedNURSING CONSIDERATIONS FOR VASODILATORSAssess:History and Physical ExamKnown allergyImpaired kidney or liver function, pregnancy or lactationBaseline status to include, VS, LS, BS, skin, ECG, and appropriate lab values
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Copyright © 2017 Wolters Kluwer • All Rights ReservedPROTOTYPE VASODILATORS
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Copyright © 2017 Wolters Kluwer • All Rights ReservedDIURETICSIncrease the excretion of sodium and water from the kidney to lower blood pressure (Figure 43.3). See Chapter 51 for a detailed discussion of these agents.Thiazide and thiazide-like diuretics: chlorothiazide (Diuril), hydrochlorothiazide (HydroDIURIL), methyclothiazide (generic), chlorthalidone (generic), indapamide (generic), and metolazone (Zaroxolyn)Potassium-sparing diuretics: amiloride (Midamor), spironolactone (Aldactone), and triamterene (Dyrenium)
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Copyright © 2017 Wolters Kluwer • All Rights ReservedANTIHYPOTENSIVE AGENTS SYMPATHETIC ADRENERGIC AGONISTS OR VASOPRESSORSIf BP becomes too low (hypotension) the vital centers in the brain and the rest of the tissues of the body may not receive sufficient oxygenated blood to continue functioningDobutamine (generic), dopamine (generic), ephedrine (generic), epinephrine (Adrenalin, AdrenaClick), isoproterenol (Isuprel), orepinephrine (Levophed), and phenylephrine (generic).
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Copyright © 2017 Wolters Kluwer • All Rights ReservedANTIHYPOTENSIVE AGENTS SYMPATHETIC ADRENERGIC AGONISTS OR VASOPRESSORSActions- Activates alpha-receptors in arteries and veins to produce an increase in vascular tone and an increase in blood pressureIndications- Symptomatic treatment of orthostatic hypotensionPharmacokinetics- Absorbed from GI tract, metabolized in the liver, and excreted in the urineContraindications- Supine hypertension, CAD, pheochromocytoma, and with urinary retention
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