Antihypertensives

Common drugs Action Contraindications Nursing Implications

Calcium Channel Amlodipine Causes smooth muscle relaxation by blocking the Hypersensitivity pt should avoid lg amounts of GF juice;
Blockers Diltiazem binding of calcium to its receptors Bradycardia Monitor BP an pulse before and during
Felodipine 2nd or 3rd degree heart block therapy; Monitor I&O; monitor serum K+,
Uncompensated CHF renal and hepatic functions

Angiotensin Captopril Inhibits angiotensen-converting enzymes, which is Known drug allergy, especially a Monitor BP and pulse frequently
Converting Enzyme Benazepril responsible for converting A1(formed through the previous reaction of angioedema Assess for angioedema; Monitor weight
Inhibitors (ACE) Enalapril action of renin) to A2. A2 is a potent vasoconstrictor (laryngeal swelling) to an ACE and assess for fluid overload; Monitor
and induces aldosterone secretion by the adrenal inhibitor BUN, creatine, and electrolytes
glands. Aldosterone stimulates sodium and water
resorption, which can raise BP.

Beta Blockers Carteolol Compete with andregenic neurotransmitters for Bradycardia Take apical pulse before admin,
Carvedilol adrengenic receptor sites Uncompensated CHF withhold <50; Monitor BP and pulse
Labetalol Acute bronchospasm frequently; Monitor I&O and daily weight;
Some forms of valvular heart Assess for fluid overload; My Increase
disease BUN, serum lipoprotein, K+,
Brady-arrhythymias triglycerides, uric acid, ANA titers,
Heart block glucose

Angiotensin II Candesartan Blocks vasoconstriction and aldosterone-producing Known drug allergies Assess BP(lying, sitting, standing)
Receptor Blockers Eprosartan effects of angiotensin II and receptor sites, including Pregnancy periodically during therapy; Monitor daily
Losartan vascular smooth muscle and the adrenal glands Lactation weight and assess for fluid overload;
Monitor renal function and electrolyte
levels. May increase serum K+, BUN
and creatinine.

Vasodilators Fenoldopam Directly elicit peripheral vasodilation which results in Known drug allergy Used short term , <48 hrs in hosp.;
Minoxidil a reduction in SVR Hypotension Monitor BP, heart rate and ECG
Nitroprusside Cerebral edema frequently throughout therapy; Monitor
Head injury serum K+ Q6 during therapy, may cause
Acute MI hypokalemia
Coronary artery disease
 Antihypertensives
Common drugs Action Contraindications Nursing Implications

Adrenergics Clonidine Dilates both arteries and veins by blocking post- Allergy Monitor I&O daily weight and assess for
Doxazosin synaptic alpha(1)-adrenergic receptors. Acute heart failure edema
Prazosin Severe mental depression Monitor BP and pulse frequently during
Peptic ulcer initial dose
Colitis May increase blood glucose
Severe kidney or liver disease Geriatric pt, increased risk of
hypotension and renal impairment