Class
Aldosterone
Antagonists
Common Names
Sprinolactone (Aldactone)
Eplerenone (Inspra)
K sparing diuretic
Alpha-1 Blockers alpha Prazosin (minipress)
Terazosin (Hytrin)
Doxazosin (Cardura)
Angiotensin Converting Enalapril (Vasotec)
Enzyme Inhibitor (ACE) Ramipril (Altace)
Captopril (Capoten)
Lisinopril (Zestril/Prinivil)
Transolapril (Mavik)
Quinapril (Accupril)
Benazepril (Lotensin)
Angiotensin II Receptor Candesartan (Atacand)
Blockers/Antagonists Irbesartan (Avapro)
Losartan (Cozzar)
(ARBs)
Valsartan (Diovan)
adrenergic agonists
Beta Blockers
aka Beta Adrenergic
Blockers
Calcium Channel
Blockers
Vasodilators
Digoxin
Atenolol (Tenormin)
Carvedilol (Coreg)
Labetalol (Normodyne)
Metroprolol (Lopressor or
Toprol)
Propranolol (Inderal)
Sotalol (Betapace)
Verapamil (Calan)
Diltiazem (Cardizem)
Amlodipine (Norvasc)
Felodipine (Plendil)
Nifedipine (Procardia,
Adalat)
Digoxin
Not used much
Loop Diuretics
(not K sparing)
Nitrates
Thiazide Diuretic
(not K sparing)
Furosemide (Lasix)
Torsemide (Denadex)
Action/Use
Uses
CHF
Action: Blocks action
HTN
of aldosterone, causing
excretion of Na, Cl, and
water BUT hold onto K
HTN
Action: Blocks alpha-1
vasoconstriction (reduce
peripheral resistence)
Action: Blocks conversion of HTN
angiotensin I to angiotensin CHF
II, promoting vasodilation. CAD
Action: Similar to ACE
resulting in vasodilation,
decreased blood volume
and prevention of ventricular
remodeling.
Action: Blocks sympathetic
nervous system (fight/
flight): decreases HR,
BP, contractility & oxygen
demand of heart
Triglycerides
Cholesterol absorption inhibitors HMG Co-A reductase inhibitors
“- statins”
- Ezetimibe (Zetia)
NOT 1st line treatment!
Monitor BP, esp for
orthostasis
HTN
CHF (If
ACE not
tolerated)
Same as ACE, but no
cough and less likely to
cause angioedema
Same as ACE
CAD
CHF
HTN
Severe bronchospasm
– do NOT give to
asthma pt, bradycardia
(<60),depression/fatigue,
may mask signs of
hypoglycemia in diabetic
patients
Monitor: HR, BP, and heart
rhythm, check for orthostasis,
assess lung sounds
Check for peripheral edema
and wt gain, esp in HF
patients
Teach diabetic pt to closely
monitor glucose levels
Check for orthostasis if pt is
dizzy/light headed
Hypotension, Dizzy
CHF
Angina
(CAD)
Digoxin toxicity, esp if low toxic s/s non specific, antacids
K levels.
affect absorption, kindey probs
cause body to hold onto it,
increases workload of the
heart
Ototoxicity Hypotension, Monitor for electrolytes (esp
dehydrate, decreased K, K), ototoxicity
Mg, and Na
Pt on Falls Precautions
Low K + digoxin = renal failure
Headache (ok to treat w/
Tylenol)
Hypotension, syncope
HTN
CHF
Same as above, but NO
ototoxicity
Action: blocks reabsorption HTN
CHF
of Na, Cl and water
Action: relaxation of
smooth muscle, significant
vasodilation, some coronary
artery dilation
Hydrochlorothiazide (HCTZ) Action: blocks reabsorption
1st Line – CHEAPEST
of Na, Cl and water
Nursing Implications
Monitor for hyperkalemia
No grapefruit juice or St.
John’s Wort
Cough, headache and
angioedema (swelling of
lips or mouth)
Action: blocks initial calcium HTN
influx into cardiac cells and CAD
vascular smooth muscle
cells. Slows conduction in
the atria and ventricles.
Vasodilates coronary
arteries
Action: Improves heart
CHF
contractility and slows AV
conduction, decreases HR
Nitroglycerin (NTG), many
routes: Sub lingual, PO,
patch, IV
Adverse Effects
Hyperkalemia,
Gynecomastia
Same as above
Encourage foods high in K
Low K + digoxin = renal failure
Omega 3 fatty acids
Bile acid-binding resins
Fish Oil
Omacar
Cholestyramine (Questran)
Colestipol
Colesevelam (Welchol)