ACE in the Hole
This class of antihypertensives block the conversion of angiotensin I to angiotensin II, causing arteriole vasodilatation and water/sodium excretion.
What are Angiotensin-converting enzyme inhibitors (ACEs)?
(Enalapril, enalaprilat, fosinopril, lisinopril, ramipril, benazepril, trandolapril)
This old diuretic is no longer a first line medication for hypertension, but still used for congestive heart failure.
What is furosemide (Lasix)?
This family of drugs reduces arterial blood pressure by blocking smooth muscle calcium channels, leading to arteriole vasodilatation.
What are calcium channel blockers?
(Nifedipine, verapamil, diltiazem, amlodipine, felodipine, nicardipine, nislodipine)
This class of medications reduces heart rate and blood pressure in the peripheral nervous system by blocking alpha1 adrenergic receptors.
What are sympatholytics or alpha adrenergic blockers?
(Doxazosin, terazosin, prazosin)
Not a true "emergency", but something all clients on antihypertensives should be warned of (one of three options).
What is beware of dizziness, rise slowly, and monitor your blood pressure daily or BID at home?
ACE's are notorious for causing a dry cough because they elevate this chemical which leads to bronchoconstriction.
What is bradykinin? (an inflammatory peptide)
This class of drugs promotes excretion of sodium and water, thereby reducing blood pressure.
What are aldosterone antagonists?
These foods and medications can lead to calcium channel blocker toxicity and should be avoided when taking Ca++ channel blockers.
What are grapefruit and grapefruit juice, cimetidine/famotidine, and digoxin?
In addition to blood pressure control use, these medications also relax smooth muscle to allow men to do this.
What is relax bladder neck to enable voiding with prostatic enlargement? (Relieve urgency/frequency/dysuria of benign prostatic hypertrophy)
These powerful vasodilators are given as titrated intravenous drips to control malignant hypertensive crisis.
What are nitroprusside and/or nitroglycerin?
In addition to monitoring blood pressure values, this serum electrolyte should be monitored when on ACE therapy.
What are serum potassium levels?
Being an endogenous chemical that is transported to other body tissues to stimulate a specific action, aldosterone is a ____?
What is a hormone?
Also known as ADH or anti-diuretic hormone.
Clients should monitor the following home parameters/symptoms when taking Ca++ channel blockers (2 out of 4).
What are blood pressure, heart rate, heart rhythms, and weight/edema development.
These drugs calm the sympathetic nervous system and result in decreased heart rate, blood pressure, and anxiety.
What are alpha-2 adrenergic agonists?
(Clonidine, guanfacine, and methyldopa)
When administering powerful vasodilators for hypertensive crisis, these parameters must be continuously monitored.
What are heart rate (cardiac rhythm) and blood pressure?
These conditions are contraindications to using angiotensin-converting enzyme medications (name 2 of four).
What are pregnancy, lactation, and kidney impairment (having one kidney or bilateral renal artery stenosis).
Because sodium and water are retained by the kidneys due to aldosterone action, this electrolyte is discarded by the kidneys in response to aldosterone.
What is potassium?
This specific calcium channel blocker may be used for preeclampsia hypertension of pregnancy.
What is nifedipine?
In addition to being antihypertensives, centrally acting alpha-2 agonists are also used for these conditions.
What are severe cancer pain, ADHD management, migraine headaches (investigational) and substance withdrawal (investigational)?
This medication can reverse cyanide poisoning caused by lengthy (more than three days) nitroprusside infusions.
What is thiosulfate?
The medical term for altered taste, this is a potential side effect of ACE medications.
What is dysgeusia?
Artificial aldosterone (ADH) will be given as treatment for this dehydrating illness.
What is diabetes insipidus?
Metoprolol (a Beta Blocker) may be used cautiously with nifedipine to control this undesired effect.
What is reflex tachycardia?
Watch for these adverse effects when first beginning centrally acting alpha-2 agonists (2 of 3)
What are dry mouth, drowsiness/sedation and hypotension (dizziness/lightheadedness)?
Nitroprusside and nitroglycerin infusions must be protected from this.
What is light?