Medications
Actions
Advantage
Contraindication
AD/SE
Nursing Indications
Thiazide Diuretic increase sodium & water excretion by inhibiting sodium reabsorption in the distal tubule of
the kidney. Used for hypertension and peripheral edema. Not effective for immediate dieresis. Used in clients
w/normal renal function.
Hydrochlorothiazide Relatively
Gout, known
dry mouth, thirst,
Monitor for signs
inexpensive,
sensitivity to
weakness, drowsiness,
of electrolyte
effective orally.
sulfonamidelethargy, muscle aches,
imbalance because
Thiazide diuretics
Effective longderived
muscular fatigue,
this causes loss of
should be used
term admin. Mild medications,
tachycardia, GI
sodium, K+, Ma.
w/caution in clients
side effects.
severely
disturbance.
Encourage intake
taking lithium
Enhances other
impaired
of K+ rich foods.
Postural hypotension
because lithium
antihypertensive kidney
GerI: risk of
may be potentiated by
toxicity can occur in meds. Counter
function, and
postural
alcohol, barbiturates,
client taking digoxin, sodium retention history of
hypotension.
opioids, or hot
corticosteroids, or
effects of other
hyponatremia.
weather/baths, strenuous Measure BP in 3
hypoglycermice
antihypertensive
positions. Caution
exercise
meds.
meds.
pt to rise slowly.
sulfa-based – allergic
i/o, lytes, FUN Cr.
reaction
Give in AM, Diet,
- at risk for hypokalemia, BUN, uric acids.
hyperglycemia,
Hypercalcemia,
hyperlipidemia and
hyperuricemia.
Loop Diuretic Inhibit sodium and chloride reabsorption. More potent than Thiazide diuretics. Causing rapid
dieresis, and thus decreasing vascular fluid volume, cardiac output and BP
Gout, known
risk of volume Geri: risk of postural
Rapid Action. Potent. sensitivity to
and elect.
hypotension. Measure BP
Used when Thiazides sulfonamideDepletion from in 3 positions. Caution pt
fail or pt needs rapid derived
the profound
to rise slowly.
dieresis.
medications,
diuresis
severely impaired occurring.
kidney function, Fluid & elec
and history of
replacement
hyponatremia.
may be req.
Bumetanide – diuretic used to decrease venous return when
client is in bed.(paroxysmal nocturnal Dyspnea due to
increased venous return)
adverse – hypotension.
monitor BP
Put on K+
supplements.
Furosemide – Administer Lasix slowly - may cause hearing
loss if injected too rapidly.
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Medications
Actions
Advantage
Contraindication
AD/SE
Nursing Indications
Potassium Sparing Diuretic – promotes sodium and water excretion and potassium retention. Used for edema
and HTN to increase urine output, fluid retention, and overload associated w/heart failure, ascites.
Causes Potassium retention
Contraindicated in
Drowsiness, lethargy,
Monitor for
Renal Disease,
headache. Hyperkalemia,
Hyperkalemia if
Azotemia, severe
N & V, diarrhea. Rash,
given with ACE
Spironolactone - Considered an
hepatic disease,
Dizziness, weakness, dry
inhibitor or
Aldosterone Receptor Blocker as
hyperkalemia
mouth photosensitivity,
Angiotensin
well as Potassium sparing diuretic.
anemia, thrombocytopenia. receptor blocker.
Diarrhea & GI
symptoms – admin.
meds after meals
Monitor Vital
signs. Monitor
Urine Output.
Avoid foods high
in K+. Avoid salt
substitutes – high
in K+.
Centrally Acting Sympatholytic (Adrenergic Blockers) Alpha Agonist – stimulate alpha receptors in the CNS
to inhibit vasoconstriction – reducing peripheral resistance.
slows pulse,
history of
Sodium and water retention, Monitor VS. Not to
which counteracts depression,
drowsiness, dizziness, dry
discontinue med – can
tachycardia of
psychosis,
mouth, Bradycardia, edema, cause severe rebound
Hydralazine
obesity,
impotence, hypotension,
hypertension. Monitor
chronic
depression.
liver function tests. Use
sinusitis, peptic May cause severe
with caution if history of
ulcer
gallbladder, renal, or
depression – but mainly
cardiac disease, or
those with depression;
report manifestations, as
seizure disorder. Geri:
this may require that drug
depression and postural
be omitted. Nasal
hypotension common in
congestion.
elderly
Methyldopa –
drowsiness, dizziness, dry
Geri: May produce
mouth; nasal congestion.
mental and behavioral
Dopa-decarboxylase, inhibitor; displaces
(troublesome at first but
changes in the elderly.
norepinephrine from storage sites.
then tends to disappear) Use
Drug of choice for pregnant women w/HTN (Laura’s with caution w/Renal
METH-Pregnant Lady) Useful in patients w/renal
Disease.
failure or prostate disease. Does not decrease cardiac
output or renal blood flow. Does not induce oliguria. Liver disease
Clonidine through CNS,
little or no
Drowsiness, dry mouth,
monitor BP when
produces blood
orthostatic
withdrawal phenomenon.
stopping medication
Patch
pressure reduction.
effect.
Moderately
sometimes is effective
If BP is above 160
potent,
when other meds fail to
give Clonidine –
lower blood pressure.
Centrally acting.
2
Medications
Actions
Advantage
Contraindication
AD/SE
Nursing Indications
CNS – Quick.
Beta Blockers block the sympathetic nervous system, especially the sympathetic to the heart, producing a
slower heart rate and lowered blood pressure. Reduces Hearts Contractility work load and oxygen demands.
Reduce pulse
Bronchial asthma, Mental depression
I/O, Wt, HR Avoid
Glucose monitoring. rate in patients allergic rhinitis,
manifested by
sudden discontinuation,
with
right ventricular
insomnia, lassitude,
check HR before giving.
Used for angina,
tachycardia
failure from
weakness, and
Geri: Risk of toxicity is
Dysrhythmia,
and BP
pulmonary
fatigue. Light
increased for elderly
hypertension,
elevation.
hypertension,
headedness &
patient w/decreased
migraine headaches,
Indicated for
heart failure,
occasional N & V,
renal and liver function.
prevention of
patients who
depression , DM,
Epigastric distress
Take BP in 3 positions
myocardial
also have
Dyslipidemia,
and observe for
infarction, and
stable angina
Heart block, PVD,
hypotension. Antacids
glaucoma.
pectoris and
HR < 50bpm,
may cause
silent
apical
malabsorption.
ischemia.
BP < 110
Atenolol
Propranolol – watch out for bronchospasms indicated by audible expiratory wheezes.
Metoprolol
Calcium Channel Blockers – Inhibit CA ion influx across membranes. Vasodilating effects on coronary and
peripheral arteriole. Decrease cardiac work and energy consumption, increase delivery of O2 to myocardium
VASODIALATORS, relax smooth muscle in vessel walls – sexual dysfunction. Used as Antirhythmic agents.
Rapid action. Effective by oral or
None (except
Muscle cramps, joint Monitor for hypotension,
sublingual route. To tendency to slow Heart Failure
stiffness, sexual
Bradycardia and pedal
SA nodal activity or prolong AV
for Nifedipine) difficulties may
edema. Administer on empty
node conduction. Isolated systolic
disappear when dose stomach. Use w/caution in
hypertension.
decreased.
diabetic patient w/diabetes.
Small frequent meals if
Used in Raynaud’s Disease
May cause dizziness
nausea.
Report irregular Heartbeat,
hyperglycemia.
constipation, SOB, edema.
Amlodipine
Felodipine
Nifedipine- for blood pressure
Nisoldipine
Diltiazem - Bradycardia due to affect on AV and SA nodes. CA blockers used to treat Arrhythmias.
Verapamil
Bradycardia due to
affect on AV and SA
nodes. CA blockers
used to treat
Arythmias.
slows velocity
of conduction
of cardiac
impulse.
Effective
antiarrhythmic
Rapid IV
onset. Blocks
SA and AV
Sinus or AV
node disease;
severe heart
failure; severe
hypotension
Bradycardia.
Administer on empty
stomach or before meal. Do
not discontinue suddenly.
Depression may subside
when medication is
discontinued. To relieve
headaches, reduce noise,
monitor electrolytes.
Decrease dose for patients
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Medications
Actions
AD/SE
Advantage
Nursing Indications
node channels.
Contraindication
with liver or renal failure.
Peripherally Acting Alpha Blocker – Decrease sympathetic vasoconstriction by reducing the effects of
norepinephrine at peripheral nerve endings, resulting in vasodilation and decreased BP
Doxazosin
Orthostatic hypotension,
Monitor VS, Fluid
Prazosin
reflex tachycardia, sodium retention , edema.
Terazosin
and water retention, GI
change positions
disturbances, N,
slowly.
drowsiness, nasal
congestion edema Weight
Gain.
Combined alpha & beta blocker
Carvedilol
Labetalol
Peripheral Vasodilators – work directly on the vessels to cause vasodilation, given for chest pain.
decrease Peripheral Resistance. Increased blood flow to extremities. Effective for disorders resulting
from vasospasm Reynaud’s disease.. May decrease symptoms of cerebral vascular insufficiency.
Hydralizine
light-headedness,
Assess Headaches
Minoxidil
dizziness, Orthostatic
Monitor for Orthostatic
Hypotension,
hypotension. BP VS HR.
Tachycardia,
inadequate blood flow – pallor,
Palpitations, Flushing,
feeling cold, pain. Instruct patient
GI distress.
it may take up to 3 months for
desired therapeutic response.
Quit smoking – increases
vasospasm.. Avoid Aspirin or
aspirin-like compounds.
Angiotensin-Converting Enzyme ACE Inhibitors and) – lowers total peripheral resistance. by blocking
Angiotensin I to Angiotensin II. Good for Heart Failure. Reduces Cardiac workload. Prevents Peripheral
Vasoconstriction.
Used to treat HTN,
PRIL
Causes
N & V, diarrhea,
check urinary protein
HF, cardioprotective Play right in
Decrease
Persistent dry cough
Monitor VS, WBC,
effect after
Las vegas you Aldosterone
hypotension
Protein, Albumin,
myocardial
need a ACE
Avoid use
Hyperkalemia
BUM, Creatinine, K+.
infarction.
with
tachycardia
Hypoglycemic
potassium
headache dizziness,
reactions.
supplements
fatigue, insomnia
Inform pt food may
and
hypoglycemic reaction in
diminish taste during
potassium=sp pt w/DM, bruising,
1st month of therapy.
aring
Petechiae, bleeding
diuretics.
Diminished Taste.
Benazepril
Captopril – take 20 – 60 minutes before a meal.
Enalapril
Fosinopril
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Medications
Actions
Advantage
Contraindication
AD/SE
Nursing Indications
Lisinopril
Ramipril
Angiotensin II receptor blockers (ARBs)– sit at receptor site on II, blocks so I can’t go to II. Produces
Vasodilation.
“artan”
Irbesartan
Losartan
Olmesatrtan
Valsartan
Normal BUN 7 – 20
Normal Creatinine 0.8 – 1.4
K+ 3.5 – 5.5 Norm
PT 11 – 13, or PTT is 1-2 times the pt’s control for warfarin
INR prophylaxis and Tx of venous thrombosis 2-3
Tx pulmonary, Prevention of systemic embolism 2-3
all other INR 3-4.5
Digoxin therapeutic 0.5 – 2ng.
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