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8 Cards in this Set
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Alpha-Adrenergic Blockers - Prazosin HCI (Minipress) - Terazosin (Hytrin) - Phenotolamine mesylate (Regitine) - Doxazosin (Cardura) |
Indication: peripheral vasodilator that acts directly on blood vessels - used in extreme HTN of pheochromocytoma
adverse reactions: orthostatic hypotension, weakness, palpitations
nursing implication: - use cautiously in older clients - occasional vomiting and diarrhea - warn clients of possible drowsiness, lack of energy, weakness |
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Combined Alpha/Beta Blocker - Labetalol (Normodyne) - Carvedilol (Coreg) |
Indications: Produces decrease in BP w/o reflex tachycardia or bradycardia
Adverse reactions: HF, ventricular dysrhthmias, blood dyscrasias, bronchospasm, orthostatic hypotension
Nursing Implication: contraindicated in HF, heart block, COPD, asthma |
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Beta blocker - Metoprolol tartrate (Lopressor) - Nadolol (Corgard) - Propranolol HCI (Inderal) - Timolol maleate (Blocadren) - Atenolol (Tenormin) - Bisoprolol (Zebeta) - Metropolol (Lopressor, Toprol) |
Indication: blocks the SNS, especially the heart, produces a slower heart rate and lower blood pressure and reduce oxygen consumption during myocardial contraction
Adverse reaction: bradycardia, fatigue, insomnia, bizarre dreams, sexual dysfunction, hypertriglyceridemia, decreased HDL, depression
Nursing implication: - check apical/radial pulse daily - monitor for GI distress - do not discontinue abruptly - watch for SOB; give cautiously with bronchospasm - Do not vary how taken (w/ or w/out food) - do not vary time taken - may mask symptom of hypoglycemia or may prolong a hypoglycemic reaction - contraindicated in asthma |
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Central-Acting Inhibitors - Clonidine (Catapres) - Guanabenz acetate (Wytensin) - Guanfacine (Tenex) - Methyldopa (Aldomet) |
Indications: Decreases BP by stimulating central alpha receptors, resulting in decreased sympathetic outflow from the brain
Adverse reaction: drowsiness, dry mouth, fatigue, sexual dysfunction
Nursing implication: watch for rebound HTN if abruptly discontinued & use with caution to make position change slowly, avoid standing still and taking hot baths and showers |
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Vasodilators - Hydralazine HCI (Apresoline) - Minoxidil (Loniten) |
Indication: decreases BP by decreasing peripheral resistance
Adverse reaction: headache, tachycardia, fluid retention (HF, pulmonary edema), postural hypotentation
Nursing implication: - monitor BP, pulse routinely - Observe for peripheral edema - Monitor I&O - Weight daily |
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Angiotensin II Receptor Antagonists - Losartan (Cozaar) - Valsartan (Diovan) - Irbesartan (Avapro) - Azilsartan (Edarbi) - Candesartan (Atacand) - Eprosartan (Teveten) - Olmesartan (Benicar) - Telmisartan (Micardis) |
Indications: blocks the vasoconstrictor and aldosterone-producing effects of angiotension II at various sites (vascular smooth muscle and adrenal glands)
Adverse reaction: hypotension, fatigue, hepatits, renal failure, hyperkalemia (rare)
Nursing implication - monitor liver enzymes, electrolutes - monitor for angioedema in those with history of it when on ACE inhibitors previouslt |
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Angiotensin-Converting Enzyme (ACE) Inhibitor - Captopril (Capoten) - Enalapril maleate (Vasotec) - Lisinopril (Zestril) - Ramipril (Altace) - Benazepril (Lotensin) - Quinapril (Accupril) - Fosinopril (Monopril) - Moexpril (Univasc) - Trandolapril (Mavik) |
Indication: - decreases BP by suppressing renin-angiotensin aldosterone system and inhibiting conversion of angiotensin I into angiotensin II - Useful with clients diagnosed with diabetes
Adverse reaction: proteinuria, neutropenia, skin rash, cough
Nursing Implication: observe for acute renal failure (reversible), routine renal function tests, remain in bed 3 hours after first dose |
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Calcium channel blocker - Diltiazem (cardizem) - Nifedipine (Procardia, Adalat) - Verapamil HCI (Calan, Isoptin) - Nisoldipine (Sular) - Felodipine (Plendil) - Nicardipine (Cardene) - Amlodipine (Norvasc) |
Indication: Inhibit calcium ion influx during cardiac depolarization, decreases SA/AV node conduction
Adverse reaction: headache, hypotension, dizziness, edema, nausea, constipation, tachycardia, HF, dry cough
Nursing implication: - check BP and pulse routinely - limit caffeine consumption - take medication before meals - avoid grapefruit juice with these drug, it increase serum level causing hypotension - high-fat meals for elevate serum level |
