Drugs Affecting Blood Pressure

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Drugs Affecting Blood Pressure
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Vasopressors

• Treat shock
• isoproterenol (Isuprel)
• stimulates beta 1 beta 2
• AE - too much beta stimulation tachycardia,
  palpitations, nervousness
• IV - need large catheter
• other common vasopressors are dopamine,
  epinephrine, norepinephrine (Levophed)

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Management of Hypertension

• Try diet modification, stress reduction,
  exercise first
• once started usually long term drug therapy,
  possibly for life
• must have follow up to monitor effectiveness of
  drug therapy
• compliance a problem
• education for patient

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ACE Inhibitors

• Prevent conversion of angiotensin I to
  angiotensin II (prevents sodium water
  retention) decreases peripheral vascular
  resistance
• Captopril food decreases absorption, give 1
  hour before meals
• chronic cough can occur
• monitor BP

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Alpha Beta Blockers

• Normodyne (labetalol)
• blocks alpha 1 beta 1 beta 2
• watch for cardiac failure
• do not stop drug suddenly

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Critical Thinking Excercise

• Your pt. is receiving labetalol for hypertension.
  Today, he has rales and has gained 3 lbs. Since
  he was last weighed 2 days ago. Urinary output
  has decreased in the last 2 days.
• What do you conclude?
• What type of orders might you seek from the
  physician or NP
• Which nursing actions would you implement?

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Alpha 2 agonists

• Inhibits sympathetic response
• decrease vasoconstriction decrease BP
• Clonidine (Catapres) side effects are dry mouth,
  drowsiness, sedation constipation
• not suited for initial monotherapy
• also used to alleviate discomfort from narcotic
  withdrawal

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Direct Acting Vasodilators

• hydralazine (apresoline) relaxes arterioles
• have reflex mechanism of increase HR CO
• administer with food
• usually given with beta blocker diuretic
  because of reflex tachycardia increase NA
  water retention
• side effects tachycardia, palpitations, angina
• used as adjunct therapy

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nitroprusside

• Hypertensive crisis
• maximum effects in 1-2 minutes
• given IV, sensitive to light
• relaxes vascular smooth muscle
• patient can get excessive hypotension
• given with other longer acting antihypertensives
  concurrently