Prevent conversion of AI to AII

Ace Inhibitors
(Action)

adrenocortical secretion of aldosterone

Reduce Na & H2O retention and ECF volume
Lowers total peripheral resistance
Slows HR

ACE Inhibitors
(Side Effects)

ACE Inhibitors
(Nursing
Implications)

Gastric irritation,
peptic ulcer,
orthostatic hypotension,
tachycardia,
myocardial infarction,
proteinuria, rash, pruritis
Persistent dry nonproductive cough,
Peripheral edema
1x Daily
Monitor Lytes and Renal Function
Decreased absorption if taken with food1hr before or 2 hr after meals
Small; frequent meals
Frequent mouth care
Change position slowly

catopril

(Capoten)

lisinopril

(Prinivil, Zestril)

benazepril

(Lotensin)

enalapril

(Vasotec)

quinapril

(Accupril)

Angiotensin
Receptor
Blockers
(Action)
Angiotensin
Receptor
Blockers
(Nursing
Implications)

Allow angiotensin I to be converted to angiotensin II,

but block the receptors that receive angiotensin II,
leading to vasodilation and decreased aldosterone
secretion
Also help preserve renal function in diabetic patients

Side Effects:
Hyperkalemia
Dizziness
Muscle cramps
Angioedema
Daily or BID
Monitor for hyperkalemia
Instruct patient about position changes
Monitor for edema
Patient to call doctor about edema

losartan

(Cozaar)

candesartan

(Atacand)

irbesartan

(Avapro)

valsartan

(Diovan)

Beta Blockers
(Action)

Block cardiac stimulating effects of epinephrine &

norepinephrine in SNS
Decreases heart rate
Decreases BP
Helps balance hearts O2 use & need
Helps control chest pain
Tx:
Conditions where there is a need to control B/P
Contitions where there is myocardial based chest
pain

Beta Blockers
(Side Effects)

HTN
Angina
PREVENT REINFARCTION AFTER MI
Gastric pain
Bronchospasm
Bradycardia/Tachycardia/Hypot Depression
ension
Constipation
Cardiac dysrhythmias
Erectile dysfunction
Dizziness
Fatigue

Beta Blockers
(Nursing
Implications)

Monitor AP & B/P

Use with caution with constrictive lung disease and
diabetes

atenolol

(Tenormin)

COPD
Acute Asthma

Do not stop drug suddenly : MI may result

Take orthostatic B/P s

metoprolol

(Lopressor)

propranolol

(Inderal)

carvedolol

(Coreg)

sotalol

(Betapace)

Hydralazine and Isosorbide Dinitrate

(Dilantrate)

Calcium Channel
Blockers
(Action)
Calcium Channel
Blockers
(Side Effects)

Inhibit calcium influx across the slow channels of

myocardial and vascular smooth muscle cells
cardiac workload and Myocardial O2 consumption
Dilate coronary arteries, peripheral arteries and
arterioles
Slows cardiac conduction from the SA to AV node
Inhibits coronary spasms;
Dilates coronary vessels
HR & B/P
Bradycardia
Hypotension
Heart failure
Peripheral edema
Constipation, nausea
Rash
Dizziness
Headache,
Flushing
Gingivitis

Calcium Channel
Blockers
(Nursing
Implications)

Monitor BP and heart rate

Contraindicated in severe hypotension and heart
block
Use with caution in patients with hepatic, renal
impairment, or heart failure
Do not discontinue suddenly.
Instruct on regular dental care because of potential
gingivitis
Administer on empty stomach or before meals

diliazem

(Cardizem)

verapamil HCL

(Calan)

nifedipine

(Procardia, Adalat)

amlodipine

(Norvasc)

First Line Therapy

Thiazide
Diuretics

Diminishes sodium reabsorption at different sites

in the nephron, thereby increasing urinary
sodium and water losses
Hypokalemia, hyperglycemia, blurred vision, dry mouth,
hypotension

-inhibit sodium and chloride reabsorption in the

ascending loop of Henle

Loop Diuretics

Hypotension, hypokalemia, hyperglycemia, GI upset,

weakness
Used for: Acute HF, Acute pulmonary edema, HTN,
Edema of HF; liver/renal disease

Retain potassium instead of wasting it

Loss of sodium, retention of potassium

Potassium
Sparing
Diuretics

Blocks action of ALDOSTERONE

Used in patients with high risk of hypokalemia
associated with diuretic use
Receiving digitalis
Cardiac arrhythmias
Hyperkalemia, hyponatremia, hepatic and renal
damage, tinnitus, rash

Often used with thiazide & loop

Diuretics

Cause loss of sodium, potassium, magnesium

monitor for signs of electrolyte imbalance
Monitor for hyperkalemia with potassium-sparing
diuretics
Administer in the AM
Monitor Weight
Teach patient to stand up slowly to prevent
orthostatic hypotension
Tx of:
HTN
CHF
Peripheral edema
Pulmonary edema

Potassium-Rich
Foods

Avocados
Bananas
Broccoli
Cantaloupe
Dried Fruits
Sunflower Seeds
Spinach
Tomatoes
Potatoes
Lima Beans
Nuts

hydrochlorothia (Hydrodiuril)
zide

metolazone

(Mykrox,
Zaroxolyn)

furosemide

(Lasix)

bumetanide

(Bumex)

torsemide

(Demedex)

spironolactone (Aldactone)