Lecture on Anti-Hypertensive Medications

Introduction

• Presented by Christine from Nurse in the Making
• Focus on anti-hypertensive medications
• Reminder to subscribe for more nursing content

Definition and Purpose

• Antihypertensive medications:
  • 'Anti' means against; 'Hypertension' is high blood pressure
  • Used to lower blood pressure and manage chronic hypertension
  • Decrease workload of the heart

Types of Antihypertensive Medications

• Memory Trick: A, B, C, D

A: ACE Inhibitors

• Mechanism:
  • Inhibit angiotensin converting enzyme
  • Prevents conversion from angiotensin I to angiotensin II (which constricts vessels)
  • Prevents aldosterone secretion (retains water and sodium)
• Suffix: -pril
  • Examples: Enalapril, Lisinopril, Captopril
• Side Effects (Memory trick: ACE):
  • Angioedema (swelling of lips, eyes, face)
  • Cough (dry cough)
  • Elevated potassium levels
• Note: Angioedema and elevated potassium are dangerous; cough is common but not dangerous.

ARBs (Angiotensin II Receptor Blockers)

• Mechanism:
  • Block receptors for angiotensin II, preventing vessel constriction
• Suffix: -sartan
  • Examples: Candesartan, Losartan, Valsartan
• Side Effects:
  • Similar to ACE inhibitors but less likely to cause cough or angioedema

B: Beta Blockers

• Mechanism:
  • Block beta-1 receptors (sympathetic nervous system)
  • Lowers heart rate and blood pressure
• Suffix: -olol
  • Examples: Metoprolol, Propanolol, Carbetolol
• Side Effects (Memory trick: Bs):
  • Bradycardia, heart blocks
  • Breathing problems (bronchospasms; avoid in asthma)
  • Bad for heart failure in acute settings
  • Blood sugar masking (masks hypoglycemia symptoms)
  • Blood pressure lowering (may cause hypotension)

C: Calcium Channel Blockers

• Mechanism:
  • Block calcium movement, reducing heart contraction strength
  • Decreases heart workload, increases oxygen supply, relaxes vessels
• Memory Trick: Very Nice Drugs
  • Verapamil, Nifedipine, Diltiazem

D: Diuretics and Digoxin

• Will be covered separately

Nursing Considerations

• Monitor for hypotension and orthostatic hypotension
• Educate on changing position slowly to prevent dizziness and falls
• Monitor electrolyte levels (potassium and sodium)
• Assess for angioedema, especially with ACE inhibitors
• Advise patients not to stop medications abruptly (rebound hypertension risk)
  • Use the rubber band analogy for explaining rebound hypertension

Conclusion

• Use the memory trick ABCD
• For more in-depth help, use NCLEX pharmacology flashcards
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• Happy studying!

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Note: Make sure to understand these concepts and potential side effects as they are commonly tested in nursing exams.