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[h]

Antihypertensives

[q] Angiotensin-Converting Enzyme (ACE) Inhibitors

[a] “Pril” meds : Captopril, Enalapril, Fosinopril, Lisinopril, Ramipril

[q] Angiotensin-Converting Enzyme (ACE) Inhibitors Side Effect 1

[a] First-dose orthostatic hypotension : Start treatment with a low dosage of the medication, stop other diuretics for 2-3 days if needed

[q] Angiotensin-Converting Enzyme (ACE) Inhibitors Side Effect 2

[a] Cough : The medication should be discontinued

[q] Angiotensin-Converting Enzyme (ACE) Inhibitors Side Effect 3

[a] Hyperkalemia, kidney failure: Monitor potassium levels. Avoid the use of salt substitutes containing potassium,

[q] Angiotensin-Converting Enzyme (ACE) Inhibitors Side Effect 4

[a] Angioedema -swelling of the tongue and oral pharynx : Stop med. Treat severe effects with subcutaneous injection of epinephrine

[q] Captopril specific side effects

[a] Rash, dysgeusia (change in taste), Neutropenia

[q] ACE and Food

[a] Captopril and moexipril should be taken at least 1 hr before meal. Other ACE inhibitors can be taken with or without food

[q] Angiotensin II Receptor Blockers (ARBs)

[a] “Sartan” drugs: Losartan, Valsartan, Olmesartan

[q] Angiotensin II Receptor Blockers (ARBs) side effect

[a] Angioedema -swelling of the tongue and oral pharynx : Stop med. Treat severe effects with subcutaneous injection of epinephrine

[q] Aldosterone Antagonists :Eplerenone, Spironolactone

[a] Reduce blood volume by blocking aldosterone receptors in the kidney, promoting excretion of sodium and water

[q] Aldosterone Antagonists Side Effects

[a] Hyperkalemia, hyponatremia, Flulike manifestations, Dizziness

[q] Aldosterone Antagonists Contraindication

[a] Clients who have high potassium levels, kidney impairment, liver impairemnet, and type 2 diabetes mellitus with albuminuria.

[q] Direct Renin Inhibitors

[a] Aliskiren – inhibit production of angiotensin

[q] Direct Renin Inhibitors side effect

[a] Allergic reaction: angioedema, Hyperkalemia, Diarrhea

[q] Aliskiren: food

[a] High-fat meals interfere with absorption

[q] Calcium Channel Blockers – Vasodialtion

[a] Nifedipine, Verapamil, Diltiazem, Amlodipine, Felodipine, Nicardipine

[q] Nifedipine side effect

[a] Reflex tachycardia, Peripheral edema, Acute toxicity

[q] Verapamil, Diltiazem Side Effects

[a] Orthostatic hypotension, Peripheral edema, Constipation, bradycardia, heart failure, Dysrhythmias, Acute toxicity

[q] Nifedipine Contraindication

[a] Acute MI, unstable angina, aortic stenosis, shock, and intestinal obstruction

[q] Verapamil Contraindication

[a] Heart block, digoxin toxicity, severe heart failure, and during lactation

[q] Calcium Channel Blockers and food

[a] No grapefruit juice

[q] Alpha Adrenergic Blockers

[a] prazosin, doxazosin, terazosin : Venous and arterial dilation, Smooth muscle relaxation

[q] Doxazosin and terazosin

[a] used to decrease manifestations of benign prostatic hyperplasia (BPH),

[q] Alpha Adrenergic Blockers Side Effect

[a] First-dose orthostatic hypotension : Start treatment with a low dosage of the medication, give at night, fall precautions

[q] Clonidine

[a] CNS Action – reduces blood pressure

[q] Clonidine other use (than treatment of hypertension)

[a] Severe cancer pain, Migraine headache, Flushing from menopause, Management of ADHD and Tourette syndrome, Management of withdrawal symptoms from alcohol, tobacco, and opioids

[q] Clonidine Side Effects

[a] Drowsiness and sedation, Dry mouth, Rebound hypertension

[q] Clonidine Nursing notes

[a] Avoid use during lactation, Dont give with other CNS depressants, ake larger dose at bedtime to decrease the occurrence of daytime sleepiness, Transdermal patches are applied every seven days

[q] Beta Adrenergic Blockers

[a] “LOL” medications: Metoprolol, Atenolol, Esmolol, Propranolol, Nadolol, Carvedilol, Labetalol

[q] metoprolol, propranolol side effect 1

[a] Bradycardia :Monitor the client’s pulse. If below 60/min, hold medication and notify the provider. It can mask tachycardia, an early sign of hypoglycemia, so careful use in DM clients

[q] metoprolol, propranolol side effect 2

[a] Decreased cardiac output, AV block :Start with low dose and titrated to the desired level, observe for signs of worsening heart failure, Obtain a baseline ECG and monitor

[q] metoprolol, propranolol side effect 3

[a] Orthostatic hypotension: Sit or lie down if experiencing dizziness or faintness, avoid sudden changes of position and rise slowly.

[q] Propranolol specifc side effect

[a] Bronchoconstriction: Avoid in clients who have asthma

[q] Beta Adrenergic Blockers contraindication

[a] Dont use for clients who have AV block and sinus bradycardia, clients who have asthma, bronchospasm,

[q] Hypertensive Crisis Medications

[a] Nitroglycerin, Nitroprusside, Nicardipine

[q] Nitropruside side effect

[a] Cyanide poisoning, Thiocyanate toxicity: Headache, and drowsiness, and may lead to cardiac arrest: Slower infusion, thiosulfate administration, hepatotoxicity

[q] NItropruside Nursing Administration

[a] Should not be administered in the same infusion as any other medication. Protect IV container and tubing from light. Solution may be light brown in color. Discrad if any other color, Discard medication after 24 hr, Vitals and ECG monitoring

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