THE NCLEX CHANNEL

{ Pharm 4.8: Cardiovascular Medications}

Session Objectives:
• Objective 1: Recall commonly prescribed cardiovascular medications (e.g., ACE inhibitors, ARBs,
beta blockers, calcium channel blockers), including why the medications may be prescribed.
• Objective 2: Identify contraindications and adverse effects of cardiovascular medications.
• Objective 3: Identify nursing considerations relevant to cardiovascular medications, including
appropriate safety and teaching considerations.

Points of Emphasis:
• Suffixes, such as -pril (for ACE inhibitors) and -sartan (for ARBs), help to identify sub-
classifications of antihypertensives.
• Antihypertensives may act by blocking the renin-angiotensin-aldosterone system (RAAS), by
blocking the sympathetic nervous system (SNS), or by causing vasodilation. Understanding the
mechanism of action helps to determine possible adverse effects and contraindications.
• ACE inhibitors and ARBs block the RAAS This lowers blood pressure and protects renal function,
but it increases the risk for hyperkalemia as well as hypotension. Angioedema is a serious
adverse effect.
• Beta-blockers, alpha-1 adrenergic receptor blockers, and centrally-acting alpha adrenergics all
block the SNS but in different locations. Monitoring the pulse is necessary for both beta-blockers
and centrally-acting alpha adrenergics. Blocking the SNS also results in lowered blood glucose
and a masking of the symptoms of hypoglycemia.
• Calcium channel blockers and direct-acting vasodilators work by causing vasodilation. However,
peripheral edema may be an adverse effect.

References:
Kaplan Test Prep. (2018). NCLEX-RN content review guide (6 ed.). New York, NY: Kaplan Publishing.
Lippincott. (2013). Nursing 2019 drug handbook (39 ed.). Philadelphia, PA: Wolters Kluwer Health.
McCuistion, L.E., Vuljoin-DiMaggio, K., Winton, M.B., & Yeager, J.L. (2018). Pharmacology: A patient-
centered nursing process approach (9th ed.). St. Louis, MO: Elsevier.