antihypertensives, heart failure drugs

• ACE inhibitors


  end in pril

  first line drugs used in the treatment of both HF and HTN

  block action of angiotensin converting enzyme
• contraindications for ACE inhibitors

  drug allergy, patients with hyperkalemia, pregnancy- black box warning for fetal toxicity
• adverse effects of ACE inhibitors

  fatigue, headache, angioedema, dry cough, hyperkalemia
• captopril 


  first available ACE inhibitor

  minimizes/prevents left ventricular dilation and dysfunction that can happen after acute MI

  improves chances of survival
• angiotensin II receptor blockers (ARBs)


  end in sartan

  block vasoconstriction and secretion of aldosterone

  used to treat HTN
• contraindications for ARBs

  allergy, pregnancy and lactation

  use in caution in renally impaired pts
• calcium channel blockers (CCBs)


  used to treat HTN, angina, dysrhythmias

  block the binding of calcium to its receptors- prevents contraction
• amlodipine, diltiazem 


  CCBs
• sodium nitroprusside 


  vasodilator used in hypertensive crisis
• inotropic drugs 


  drugs that increase the force of myocardial contraction
• chronotropic drugs

  drugs that increase the rate at which the heart beats
• dromotropic drugs 


  drugs that accelerate conduction
• lisinopril 


  commonly used ACE inhibitor used to treat HTN, HF, acute MI

  can cause dry cough, and hyperkalemia, decrease in renal function
• difference between ACE inhibitors and ARBs

  ACE inhibitors will cause a dry cough, and hyperkalemia and ARBs will not
• beta blockers 


  end in LOL

  work by reducing or blocking SNS stimulation to the heart and hearts conduction system

  reduce HR, delay AV node conduction, reduce myocardial contractility
• dobutamine 


  beta 1- selective vasoactive adrenergic drug

  similar to dopamine

  increases cardiac output by increasing contractility and stroke volume
• digoxin 


  cardiac glycoside used to treat systolic HF and A-fib

  decreases rate of electrical conduction in the heart, prolongs refractory period, reduces HR
• contraindications for Digoxin 


  allergy, second or third degree heart block, ventricular fib, diastolic HF
• adverse effects of Dig

  • bradycardia
  • hypotension
  • confusion
  • yellow halo vision
  • nausea, vomit, anorexia
• nursing education for dig

  low theraputic index: o.5-2 ng/mL

  levels need to be monitored

  hypokalemia increases potential for dig toxicity
• antidote for Dig 


  Dig immune fab
• when do we hold the dose of a beta blocker

  HR below 60 and a systolic BP under 100
• contraindications for beta blockers

  do not give for COPD or asthma pts
• education for beta blockers

  beta blockers can mask hypoglycemia- regular BS checks