Key Concepts: Antihypertensive drugs and Diuretics- Types of hypertensiono Primaryo Secondaryo Malignant hypertension- Goal of antihypertensive drug therapy- Cardiac output and blood pressureo Vasoconstriction = increased afterload and preloado Sodium retention = increased preloado Increases SNS activity = increased contractility and HR- Termso Inotropeo Dromotropeo Chronotrope- Beta blockerso See ANS key concepts for basicso Why would a beta blocker be used to treat HTN?o Kinetics: large first pass effect (why is this important to know?)o CYP inhibitors can increase level of beta blockerso Drugs that could inhibit effect of beta blockerso Drugs that could potentiate effect of beta blockerso Caution in patients having allergy testing or who have allergic conditionso Caution in diabeticso Proactivity- Alpha 1 blockerso See ANS key conceptso Why might patients taking this drug develop nasal congestion?o Why might they develop edema?o What type of sexual dysfunction could occur with this drug?o Proactivity Teach to move slowly- Alpha 2 agonists See ANS key concepts- ACE inhibitorso Action and effect Accumulation of bradykinin – why is this important?o Used to treat HTN, CHF, and protect kidneys in renal failure How does it protect kidneys?o Side effects First dose effects Common side effects Serious side effectso Drug interactions K sparing diuretics Potassium supplements Other antihypertensive drugs Proactivity- Teach- Assess- Prevent pregnancy- ARBso How do they differ from ACE inhibitors?- Calcium channel blockerso Dihydropyridines versus nondihydropyridineso Useso Side effects Must know side effects that are particular to each subclass of calcium channel blockers- Dihydros – dilate only, thus low BP, edema.- Nondihydros dilate and affect node, so more cardiac side effectso Proactivity Teach Assess- Diureticso Loops, thiazides, potassium sparingo All inhibit reabsorption of sodium Causes excess water to leave body- Decreases preloado Loops Action and effect Sulfonamide molecule Side effects- Potassium- Ototoxicity Lithium toxicity Treatment of hypokalemia- Potassium supplementationo Routes availableo How fast can you give IV?o Major complications of potassium replacemento Thiazides Action and effect Contraindicated in patients with creatinine of 2.5 or greater Side effects- Skin- Potassiumo Potassium-sparing Two types – spironolactone and triamterene Side effects for each drugs Side effects common to both drugs Drug interactions common to both drugs- All diuretics require the nurse to monitor:o Weighto Potassiumo Blood pressure, lung sounds,
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