Diuretics
Which medication class and generic named drug block reabsorption of Na, Cl, and water in the proximal portion of the distal tubules?
How and when should captopril be taken?
What is orally 2-3 times a day and no food within 1 hour
What are the therapeutic uses for nidedipine?
What is treats mild to moderate hypertension, angina, and cardiac dysrhythmias
What is the therapeutic use of doxazosin versus the therapeutic use of clonidine?
What is the therapeutic use of doxazosin is it treats hypertension and benign prostatic hyperplasia
What is the therapeutic use of clonidine is it treats hypertension and serves as an off label use for anxiety and ADHD
Which medication(s) should not be given if the patient has asthma because it increases the risk for bronchoconstriction and further exacerbation of the condition?
What are carvedilol and atenolol because these medications block beta 2 receptors which are responsible for vasodilation of the lungs
What are the adverse drug reactions of furosemide and hydrochlorothiazide respectively (Name three for each)?
furosemide:
Hypotension, orthostatic hypotension, ototoxicity, mask symptoms of hyperglyemia, and hypokalemia
hydrochlorothiazide:
Hyperglycemia, hyperuricemia, fluid and electrolyte imbalance
What is the therapeutic use of losartan?
What is blocks the angiotensin II receptors which causes vasodilation, increased urination of sodium and water, and retention of potassium
What are interactions that patient's taking calcium channel blockers need to watch out for?
What is beta blockers increase the risk for heart failure, St John's Wort decrease effects, and grapefruit juice has an additive effect
What are the adverse drug reactions of doxazosin and clonidine respectively (Name three for each)?
What is the adverse drug reactions of doxazosin are orthostatic hypotension with the first dose, headache and dizziness, and reflex tachycardia
What is the adverse drug reactions of clonidine are drowsniess, dizziness, xerostomia, rebound hypertension if stopped abruptly, and with a high dose: sedation, euphoria, and hallucinations
What is the therapeutic use of carvedilol is trates hypertension and heart failure. What is the mechanism of action of carvedilol is it blocks alpha and beta receptors in the heart, arterioles, and kidneys (dilates arterioles, reduces heart rate and contractility, and decreases renin release)
How and when should HCTZ be taken?
What is orally with food and before 5pm
(other options: Tablets or IV)
What are the adverse drug reactions of captopril and losartan respectively (Name three for each)?
captopril:
Severe hypotension, metallic taste, rash, dry persistent cough, hyperkalemia, neutropenia, and angioedema
losartan:
Hypotension, headache, dizziness, and insomnia
What are the adverse drug reactions of nifedipine (Name at least three)?
Reflex tachycardia, headache, light headedness, dizziness, edema, facial flushing, and arrhthymia
What is the mechanism of action for clonidine? What is the mechanism of action for doxazosin?
doxazosin:
Blocks alpha 1 receptors on vascular smooth muscle, dilates arterioles and veins, decreases peripheral resistance, and decreases venous return to the heart
clonidine:
Stimulates alpha 2 receptors in the CNS, and decreases stimulation of heart/blood vessles which decreases norepinephrine release which decreases blood pressure
What is the therapeutic use and mechanism of action of atenolol?
What is the therapeutic use of atenolol is treats hypertension.
What is the mechanism of action of atenolol blocks the beta 1 receptors sites in the heart and kidneys (decreases heart rate and contractility, decreases peripheral vascular resistance, and decreases renin release)
What are the possible interactions that we need to look out for when the patient is taking furosemide?
What is digoxin + hypokalemia = digoxin toxicity, diuretics + NSAIDs = decreased effects, lithium toxicity, and amphotericin B + corticosteriods = increased risk of hypokalemia
What are nursing interventions/education for captopril?
What is monitor blood pressure following first dose, monitor for adverse drug reactions, monitor blood pressure before each dose, and dose may be started low and gradually increase to reduce the risk of side effects
What is the mechanism of action for nifedipine?
What is it blocks calcium channels in the smooth muscles of peripheral and cardiac arteries which causes vasodilation
When and how should Alpha 1 Blockers and Centrally Acting Alpha 2 Agonists be administered?
What is Alpha 1 Blockers should be administered orally before bed (HS) while Centrally Acting Alpha 2 Receptors should be administered orally before bed (HS) or by patch (apply by patch and change every 7 days)
What are the adverse drug reactions of carvedilol and atenolol respectively (Name three for each)?
carvedilol:
Dizziness, hypotension, bradycardia, orthostatic hypotension, bradycardia, heart block, reduced cardiac output, and bronchoconstriction
atenolol:
Bradycardia and heart failure
What are the nursing interventions for HCTZ and furosemide respectively?
HCTZ:
Monitor electrolytes level closely, monitor for dysrhthmias, potassium supplements may also be added if patient is at risk for hypokalemia, monitor blood glucose levels for patients with DM, and monitor uric acid levels
furosemide:
Monitor electrolyte levels, monitor for signs of electrolyte imbalance, monitor patient's blood pressure, ensure patients are not taking any other ototoxic drugs, monitor for hearing loss and tell patients to report tinnitus or vertigo, and monitor blood glucose levels and uric acid levels
What are the benefits of taking captopril over losartan? What are the benefits of taking losartan over captopril?
Taking captopril over losartan benefits:
ACEIs are more protective from severe cardiovascular events
Taking losartan over captopril benefits:
No cough or hyperkalemia and no first dose hypotension
What are nursing interventions/education for a patient taking nifedipine?
What is may be given alongside beta blockers to prevent tachycardia, monitor patient's heart rates and blood pressure before each dose, monitor for adverse drug reactions, advise patients to have regular dental checkups, hold medication if heart rate is below 60bpm, and inform patient that facial flushing may occur
What are the nursing interventions for clonidine?
What is monitor patients for CNS effects, inform patients that dryness of mouth will decrease after a few weeks and advise sipping water or sucking on candy, and ensure that the dose is tapered off slowly under the care of a provider
What are the nursing interventions/education for beta blockers and for Alpha 1/Beta Blockers respectively
What is the nursing intervention/education for Beta Blockers are to monitor heart rate and report to the provider if bpm is below 50, monitor for signs of heart failure, monitor for adverse reactions, hold medication if heart rate is less than 60, and do not stop medication immediately
What is the nursing intervention/education for Alpha 1/Beta Blockers are to monitor blood pressure and report hypotension, monitor heart rate and report if heart rate is less than 60bpm, hold medication if heart rate is less than 60bpm, monitor for adverse effects, and taper slowly under provider care