Cardiovascular Drugs

Beta-Adrenergic Blockers
Prototype Action Atenolol (Tenormin) Propranolol (Inderal) Metoprolol (Lopressor) blocks beta receptors in heart; excitability of heart; reduces cardiac workload and oxygen consumption; release of renin; lowers BP by reducing CNS stimuli

Calcium Channel Blockers

Nifedipine (Procardia) Verapamil (Calan) Diltiazem (Cardizem) blocks calcium access to cells causing: contractility + conductivity of the heart resulting in demand for O2. > oxygenation of myocardial cells

ACE Inhibitors
Captopril (Capoten) Enalapril (Vasotec) Benazepril (Lotensin) blocks ACE in lungs from converting angiotensin I to angiotensin II (powerful vasoconstrictor); causes BP, aldosterone secretion, sodium and fluid loss

Diuretics

Indications

Contraindicatio ns Caution

SE/Adverse

HTN (used with diuretics), angina, supraventricular tachycardia, prevent recurrent MI, migraine headache, stage fright (Propranolol) & heart failure breastfeeding, children, hypersensitivity, heart block, K-sparing diuretics, bilateral renal artery stenosis, angioedema dialysis pts., hypovolemia, leukemia, scleroderma, SLE, blood dyscrasias, CHF, diabetes mellitus, thyroid/renal/hepatic disease, COPD, asthma bradycardia, lethargy, GI disturbance, CHF, BP, depression, dizziness

Angina, HTN, dysrhythmias, interstitial cystitis, migraines heart block,

HTN, CHF

Loop diuretics inhibit Na and Cl reabsorption through direct action primarily in the ascending loop of Henle but also in the proximal and distal tubules. Thiazide diuretics act primarily on the distal tubules, habiting Na and Cl reabsorption. Edema (heart, liver, or kidney), HTN Pregnancy, breastfeeding, severe adrenocortical impairement, anuria, oliguria Fluid & electrolyte depletion, gout

BP, Bradycardia, may precipitate A-V block, headache, abdominal discomfort (constipation, nausea), peripheral edema

dizziness, orthostatic hypotension, GI distress, nonproductive cough, headache

Drug-Drug Interventions

K-sparing diuretics, sympathomimetics, K+ supplements - Do not discontinue abruptly, taper gradually over 2 wks, take with meals, provide rest periods, for diabetic pts., block normal signs of hypoglycemia (sweating, tachycardia); monitor blood glucose, medications have antianginal and antiarrhythmic actions

- Monitor v/s, do not chew or divide sustained-release tablets, medications also have antianginal actions, contact HCP if BP < 90/60, instruct pt. to avoid grapefruit juice (verapamil), monitor for signs of HF

- absorption if taken with food- give 1 h ac or 2 h pc, small, frequent meals, frequent mouth care, change position slowly, can be used with thiazide diuretics

Dehydration, hyponatremia, hypochloremia, hypokalemia, unusual tiredness, weakness, dizziness, irregular heartbeat, weak pulse, orthostatic hypotension, tinnitus, hyperglycemia, hearing loss Digitalis, lithium, NSAIDS, & other antihypertensive meds - monitor for adequate I&O and K+ loss, monitor for weight and v/s, monitor for S&S of hearing loss, which may last 1-24 hrs, teach pt. to take meds early in the day, teach to report any hearing loss or signs of gout