Professional Documents
Culture Documents
Pharmacologic Agents
NR33
K Burger, MSEd, MSN, RN, CNE
Referenced from:
Lilley et al (2005)
Pharmacology and the nursing process (4th ed). Elsevier
Categories
Adrenergic agents
-Alpha blockers
-Beta blockers
-Alpha/Beta blockers
Angiotensin-converting enzyme inhibitors
Angiotensin II receptor blockers
Calcium channel blockers
Vasodilators
Diuretics
Components of Blood Pressure
atenolol (Tenormin)
metoprolol (Lopressor)
propranolol (Inderal)
Block SNS stimulation of heart; reduces SA node activity
Reduces ventricular contraction rate
Reduction in cardiac output results in lower BP
Also used as: Antidysrhythmic, Antianginal
Adrenergic Agents
Alpha / Beta Blocker Combination
Carvedilol ( Coreg )
captopril (Capoten)
Short half-life, must be dosed more
frequently than others
enalapril (Vasotec)
The only ACE inhibitor available in oral and
parenteral forms
Newer agents, long half-lives, once-a-day
dosing
ACE Inhibitors
Nursing Implications
Losartan ( Cozaar )
Valsartan ( Diovan )
Block the binding of Angiotensin II to AT1
receptors on vessels & adrenal gland thereby:
- promoting vasodilation / lower aldosterone
- decreased SVR and decreased BP
Newer class and well-tolerated
ARB
Nursing Implications
Diltiazem (Cardizem)
Verapamil ( Calan )
Nifedipine ( Procardia )
Cause smooth muscle relaxation by blocking the
binding of calcium to its receptors, preventing
muscle contraction
This causes decreased peripheral smooth muscle
tone, decreased SVR and BP
Slows cardiac conduction; decreases HR&CO&BP
Also used as : antidysrythmic, antianginal
Calcium Channel Blockers
Nursing Implications
Hydralazine
Side Effects: dizziness, headache, anxiety,
tachycardia
Sodium Nitroprusside
Side Effects: bradycardia, hypotension
Controlled administration/IV infusion pump
CHECKPOINT
The physician has ordered prazosin
(Minipress) for Mrs. McAdams. What patient
teaching should she receive?
Main classifications:
Thiazide and thiazide-like
Loop
Potassium-sparing
Others:
Osmotic
Carbonic Anhydrase Inhibitors
Thiazide Diuretics
Hydrochlorothiazide ( HydroDIURIL )
Inhibits Na reabsorption at distal tubule
resulting in diuresis; decreased SVR & BP
Also acts to relax arterioles;decrease SVR
First line medication regimen for HTN
Safe for most patients; inexpensive
Often used in combination w/ other drugs
Loop Diuretics
Furosemide (Lasix)
Blocks Cl and Na reabsorption at Loop of
Henle resulting in diuresis; decreased SVR
and decreased BP
Stimulate prostaglandins; vasodilation of
renal, lung, system vessels
Rapid onset and most potent diuretic
Can be given once daily
Effective even in renal impaired patients
Thiazide and Loop Diuretics
Nursing Implications
Monitor K levels closely for hypokalemia
Teach patient to eat high K foods
Cross allergies may exist to sulfonamides
Concurrent digoxin Rx may lead to digoxin
toxicity
NSAIDS may decrease diuretic effect
Concurrent antiglycemic Rx may lead to
hyperglycemia
Monitor for I & O.
NCLEX QUESTION