Transcript Nitroglycerin

Drugs Affecting Blood
Pressure
Brenda B. Rowe
Vasopressors







Treat shock
Dopamine (Intropin) – stimulates alpha-1 &
beta-1
Isoproterenol (Isuprel)
Stimulates beta 1 & beta 2
AE – too much beta stimulation – tachycardia,
palpitations, nervousness
IV – need large catheter
Other common vasopressors are epinephrine &
norepinephrine (Levophed)
Management of Hypertension
Stepped Program





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
ACE Inhibitors




Prevent conversion of angiotensin I to
angiotensin II (prevents sodium & water
retention) & decreases peripheral vascular
resistance
Captopril (Capoten): food decreases
absorption, give 1 hour before meals
chronic cough can occur
monitor BP
Alpha & Beta Blockers




Normodyne (labetalol)
blocks alpha 1 & beta 1 & beta 2
watch for cardiac failure
do not stop drug suddenly
Critical Thinking Exercise




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?
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
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
nitroprusside (Nipride)






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