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| Question | Answer |
| ACE INHIBITORS Example & Action | Example: Fosinopril Action: Prevents the conversion of angiotensin I to angiotensin II by inhibiting ACE → reduced peripheral vascular resistance |
| ACE INHIBITORS Indication and adverse reactions | Indication: Mild to moderate hypertension, MI, congestive heart failure Adverse reactions: Palpitations, hypotension, tachycardia, headache |
| ACE INHIBITORS Nursing Care Considerations | • Monitor vital signs closely, especially BP • Report rash, sore throat immediately – leukopenia (decreased WBC) • Monitor serum urea and electrolytes |
| ANGIOTENSIN II RECEPTOR ANTAGONISTS Example and action | Example: Irbesartan Action: Directly block the vasoconstriction effects of angiotensin II |
| ANGIOTENSIN II RECEPTOR ANTAGONISTS Indication and adverse reactions | Indication: Mild to moderate hypertension, heart failure Adverse reactions: Hypotension, dizziness, isomnia, abdominal cramps |
| ANGIOTENSIN II RECEPTOR ANTAGONISTS Nursing Care Considerations | • Monitor vital signs closely, especially BP • Monitor serum urea and electrolytes |
| ALPHA BLOCKERS Example and Action | Example: Prazosin Action: Block alpha I adrenergic receptors in arterioles and veins leading to reduced peripheral vascular resistance and venous return |
| ALPHA BLOCKERS Indication and adverse reactions | Indication: Hypertension, benign prostatic hypertrophy, congestive heart failure Adverse reactions: Headache, drowsiness, lightheadedness, weakness, fatigue, dry mouth, blurred vision, nausea, vomiting, rash |
| ALPHA BLOCKERS Nursing Care Considerations | • Advise PT to take before sleep to avoid first dose effect • Caution to those with CAD/IHD, angina, cerebral/coronary arteriosclerosis • Not recommended in those with CCF caused by aortic/mitral valve stenosis, pulmonary embolism/ where a fall in BP is not desirable |
| BETA BLOCKERS Example and Action | Example: Non selective - proponolol, selective - Atenolol Action: Inhibits beta-adrenoceptors (SNS) → reduces some of the body’s response to adrenaline → decreases HR, myocardial contractibility, CO, BP and myocardial oxygen demand. |
| BETA BLOCKERS Indication and adverse reactions | Indication: Hypertension, angina pectoris, cardiac arrhythmia, MI, tachycardia Adverse reactions: Bronchospasm (non-selective), hypotension, bradycardia, heartblock, dizziness, exacerbation of angina, abdominal pain |
| BETA BLOCKERS Nursing Care Considerations | • Monitor vital signs closely, especially BP and pulse rate, withhold if <50bpm • Educate about postural hypotension • Monitor for early signs of hypoglycaemia (tachycardia) • Extreme caution with PTs with asthma, bronchospasm and COPD |
| CALCIUM CHANNEL BLOCKERS Example and Action | Example: Verapamil Action:Block the influx of calcium ions during depolarisation of cardiac and smooth muscle → improved myocardial oxygen supply and CO →reduced cardiac workload and HR |
| CALCIUM CHANNEL BLOCKERS Indication and adverse reactions | Indication: Hypertension, arrhythmia, angina pectoris Adverse reactions: Hypotension, dizziness, headache, constipation, diarrhoea, taste disturbance, gingival hyperplasia, peripheral oedema, dry mouth |
| CALCIUM CHANNEL BLOCKERS Nursing Care Considerations | • Monitor vital signs closely, especially BP and pulse rate • Encourage meticulous oral hygiene • Report skin reactions that persists immediately |
| LOOP DIURETICS Example and Action | Example: Frusemide Action: Inhibits the reabsorption of sodium and chloride in the medullary portion of the ascending loop of Henle, interstitial fluid become hypotonic, fluid moves out of the collecting duct. Calcium and magnesium reabsorption is also inhibited |
| LOOP DIURETICS Indication and adverse reactions | Indication: Hypertension, oedema, Heart failure, cirrhosis, renal impairment, hypercalcaemia Adverse reactions: hypotension, dehydration, fluid and electrolyte disturbance, dry mouth, muscle cramps, dizziness |
| LOOP DIURETICS Nursing Care Considerations | • Any induced electrolyte imbalances should be corrected before therapy • Monitor serum electrolytes and blood urea nitrogen (BUN) regularly • Encourage salt in diet • PT with diabetes should closely monitor their BGL during therapy • PT education – report signs of hearing loss or ringing in ears |
| THIAZIDE DIURETIC Example and Indication | Example: Hydrochlorthiazide Indication: Inhibits the reabsorption of sodium and chloride in the proximal segment of the distal convoluted tubule. Promote excretion of water, sodium, chloride, potassium and magnesium |
| THIAZIDE DIURETIC Indication and adverse reactions | Indication: Hypertension, oedema Adverse reactions: Fluid and electrolyte disturbances, hypovolaemia, hypokalaemia, dehydration, dizziness, GI upset, hypotension |
| THIAZIDE DIURETIC Nursing Care Considerations | • Monitor vital signs and hydration status closely • Caution in patients with diabetes |
| POTASSIUM SPARING DIURETICS Example and Action | Example: Spironolactone Action: Blocks the action of Aldosterone in the distal convoluted tubule causing sodium excretion but not potassium. |
| POTASSIUM SPARING DIURETICS Indication and adverse reactions | Indication: Hypertension, oedema, cirrhosis Adverse reactions: Fluid and electrolyte imbalances, hyperkalaemia, postural hypotension, muscle cramps, weakness, dizziness |
| POTASSIUM SPARING DIURETICS Nursing Care Considerations | • Renal function and electrolyte levels should be checked before and throughout therapy • Monitor vital signs and hydration status closely • Caution in patients with diabetes |
| OSMOTIC DIURETICS Example and Action | Example: Mannitol Action: Work by directly interfering with osmosis by maintaining a high osmotic pressure in the tubules leading to water secretion. |
| OSMOTIC DIURETICS Indication and adverse reactions | Indication: Raised intracranial pressure, oedema, raised intraocular pressure (glaucoma) Adverse reactions: dehydration, Hypovolemia, hypotension, hypertension, arrhythmia, nausea, vomiting, chills, fever |
| OSMOTIC DIURETIC Nursing Care Considerations | • Monitor serum electrolytes and osmolarity levels closely • Monitor vital signs and hydration status closely |
| CARBONIC ANHYDRASE INHIBITOR Example and Action | Example: Acetaxolamide Action: Blocks the enzyme carbonic anhydrase → increased secretion of bicarbonate, sodium and water |
| CARBONIC ANHYDRASE INHIBITOR Indication and Adverse reactions | Indication: glaucoma, some types of epilepsy, cardiac and drug induced oedema Adverse reactions: Disturbances in acid-base and electrolyte imbalance, metabolic acidosis, hypokalaemia, tingling of extremities, confusion and drowsiness |
| CARBONIC ANHYDRASE INHIBITOR Nursing Care Considerations | • FBC, platelet count and serum electrolyte should be monitored before and throughout therapy • PTs with diabetes should closely monitor their BGL during therapy • Monitor fluid intake and output |
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