Antihypertensive Drugs

• High blood pressure is common condition that affects the body’s arteries.
• If you have high blood pressure, the force of the blood pushing against the artery walls is consistently too high. The heart has to work harder to pump.
• Blood pressure is measured in millimeters of mercury (mm/Hg).
• In general, hypertension is a blood pressure reading of 130/80 mm/Hg or higher.
• 120/80 mm/Hg or lower - NORMAL BP
• Elevated BP - the top number ranges from 120 to 129 mm/Hg and the bottom number is below, not above, 80 mm/Hg.
• Stage 1 HPN: the top number ranges from 130 to 139 mm/Hg or the bottom number is between 80 and 89 mm/Hg.
• Stage 2 HPN: the top number is 140 mm/Hg or higher or the bottom number is 90 mm/Hg or higher.
• Hypertension Symptoms

  Headaches

  Shortness of breath

  Nosebleeds
• Cause of Hypertension

  The amount of blood the heart pumps and how hard it is for the blood to move through the arteries. The more blood the heart pumps and the narrower the arteries, the higher the blood pressure.
• Primary HPN - also called essential HPN.
• Primary HPN - This type of high blood pressure has no identifiable cause.
• Primary HPN - It tends to develop gradually over many years.
• Primary HPN - Plaque buildup in the arteries, called atherosclerosis, increases the risk of high blood pressure.
• Secondary HPN - a type of high blood pressure which is caused by an underlying condition.
• Secondary HPN - It tends to appear suddenly and cause higher blood pressure than does primary HPN.
• Conditions and medicines that can lead to secondary HPN

  • Adrenal gland tumors
  • Blood vessel problems present at birth, also called congenital heart defects.
  • Cough and cold medicines, some pain relievers, birth control pills, and other prescription drugs
  • Illegal drugs, such as cocaine and amphetamines
  • Kidney disease
  • Obstructive sleep apnea
  • Thyroid problems
• CALCIUM CHANNEL BLOCKERS – used to prevent calcium from entering the cells of the heart and arteries.
• Calcium causes the heart and arteries to squeeze (contract) more strongly.
• By blocking calcium, calcium channel blockers allow vessels to relax and open.
• CALCIUM CHANNEL BLOCKERS

  Amlodipine

  Felodipine

  Nicardipine

  Nifedipine

  Verapamil

  Diltiazem
• S/E OF CALCIUM CHANNEL BLOCKERS

  • Constipation
  • Dizziness
  • Fast heartbeat (palpitations)
  • Fatigue
  • Flushing
  • Headache
  • Nausea
  • Rash
  • Swelling in the feet and lower legs
• Advise patient to avoid taking CCB with grapefruit products. It interacts with the drug and can affect heart rate and BP. This can cause symptoms such as headache and dizziness.
• CALCIUM CHANNEL BLOCKERS

  Monitor BP and heart rate regularly. Check them at least 30 minutes before the drug is given.
• CALCIUM CHANNEL BLOCKERS

  Ensure that patient do not chew or divide sustained-release tablets. Swallow whole with a glass of water.
• ACE INHIBITORS – drugs that help relax the veins and arteries to lower blood pressure.
• ACE INHIBITORS - prevent an enzyme in the body from producing angiotensin II, a substance that narrows blood vessels.
• ACE INHIBITORS

  Lisinopril

  Ramipril

  Perindopril

  Captopril
• S/E OF ACE INHIBITORS

  • Dry cough
  • Increased potassium levels in the blood (hyperkalemia)
  • Fatigue
  • Dizziness from blood pressure going too low
  • Headaches
  • Loss of taste
• ACE INHIBITORS

  Advise patient not to take with NSAIDs such as ibuprofen and naproxen sodium. NSAIDs decrease the effectiveness of ACE inhibitors.
• ACE INHIBITORS

  Advise patient not to use salt substitutes or potassium supplements unless recommended by the AP.
• ACE INHIBITORS

  Captopril should be taken on an empty stomach… other ACE inhibitors can be taken with or without food.
• DIURETICS - help the body get rid of salt (sodium) and water. Most of these medicines help the kidneys release more sodium into the urine.
• DIURETICS

  The sodium helps remove water from the blood, decreasing the amount of fluid flowing through the veins and arteries. This reduces blood pressure.
• THIAZIDE DIURETICS

  Chlorthalidone

  Indapamide

  Chlorothiazide
• LOOP DIURETICS

  Furosemide

  Bumetanide
• POTASSIUM-SPARING DIURETICS

  Amiloride

  Eplerenone

  Spironolactone
• S/E OF DIURETICS

  • Increased urination
  • Sodium loss
  • Hypokalemia (thiazide)
  • Hyperkalemia (potassium-sparing)
  • Dizziness
  • Headaches
  • Dehydration
  • Muscle cramps
  • Joint disorders (gout)
  • impotence
• DIURETICS

  Follow BUN and creatinine levels regularly.
• DIURETICS

  Administer diuretics in the morning to prevent nocturia.