Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
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