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Drugs Affecting Blood Pressure

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

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Drugs Affecting Blood Pressure

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  1. Drugs Affecting Blood Pressure Brenda B. Rowe

  2. 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)

  3. Management of HypertensionStepped 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

  4. 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

  5. Alpha & Beta Blockers • Normodyne (labetalol) • blocks alpha 1 & beta 1 & beta 2 • watch for cardiac failure • do not stop drug suddenly

  6. 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?

  7. 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

  8. 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 • used as adjunct therapy

  9. 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

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