NR 293: Ch. 22 Antihypertensive Drugs

Younger than 60 with chronic kidney disease or diabetes

140/90

60 years or older

150/90

What are the medications used to treat hypertension?

Adrenergic drugs Angiotensin-converting enzyme (ACE) inhibitors Angiotensin II receptor blockers (ARBs) Calcium channel blockers (CCBs) Diuretics Vasodilators Direct renin inhibitors

What are the 5 subcategories of Adrenergic drugs used to treat hypertension?

Adrenergic neuron blockers (central and peripheral) Alpha2 receptor agonists (central) Alpha1 receptor blockers (peripheral) Beta receptor blockers (peripheral) Combination alpha1 and beta receptor blockers (peripheral).

Why would you use an adrenergic drug?

All used to treat hypertension Glaucoma BPH: doxazosin, prazosin, and terazosin Management of severe heart failure (HF) when used with cardiac glycosides and diuretics

What do the peripherally acting alpha 1 blockers do?

Block alpha1-adrenergic receptors When alpha1-adrenergic receptors are blocked, BP is decreased. Dilate arteries and veins Alpha1 blockers also increase urinary flow rates and decrease outflow obstruction by preventing smooth muscle contractions in the bladder neck and urethra. Use: benign prostatic hyperplasia (BPH)

What are the most common adverse effects of adrenergic drugs?

Bradycardia with reflex tachycardia Dry mouth Drowsiness, sedation Constipation Depression Edema Sexual dysfunction Headaches Sleep disturbances Nausea Rash Cardiac disturbances (palpitations), others

BP = _________ x ____________

CO x SVR

What are the 2 centrally acting adrenergic drugs?

Clonidine Methyldope

When administering an alpha-adrenergic drug for hypertension, it is most important for the nurse to assess the patient for the development of A. hypotension. B. hyperkalemia. C. oliguria. D. respiratory distress.

Correct answer: A Rationale: These drugs have strong vasodilating properties and may cause severe hypotension, especially at the beginning of therapy.

What are the peripherally acting alpha 1 blockers?

Doxazosin Prazosin Terazosin

What do they do?

Dual antihypertensive effects of reduction in heart rate (beta1 receptor blockade) and vasodilation (alpha1 receptor blockade)

If a person has an unknown cause of hypertension it is considered:

Essential hypertension Idiopathic hypertension Primary hypertension

What are the Dual-Action Alpha 1 and Beta Receptor Blockers?

Labetalol Carvedilol

What are the Beta Blockers used to treat hypertension?

Propranolol Metoprolol Atenolol

What do the beta blockers do?

Reduction of the heart rate through beta1 receptor blockade Cause reduced secretion of renin Long-term use causes reduced peripheral vascular resistance.

Clonidine and Methyldopa

Stimulate alpha2-adrenergic receptors in the brain Decrease sympathetic outflow from the central nervous system Decrease norepinephrine production Stimulate alpha2-adrenergic receptors, thus reducing renin activity in the kidneys Result in decreased BP

Hypertension =

high BP

Adrenergic drugs have a high incidence of ___________________?

orthostatic hypotension

If a person has a known cause of hypertension it is considered:

secondary hypertension