Cont..

Potassium chloride

Indication for use

• Treatment or prevention of hypokalemia
α1- adrenergic antagonists: Doxazosin
• treatment of mild alkalosis
Indications for use
Mechanism of action
• hypertension, urinary outflow obstruction, symptoms of benign prostatic hyperplasia
• Mimics endogenous potassium ions
Desired effects
Mechanisms of Action
• Maintain potassium balance
• Acts by selectively blocking the alpha 1-adrenergic receptors in the vascular smooth muscle
Adverse effects
• Nausea and vomiting, hyperkalaemia
• Dilates peripheral blood vessels, ↓ peripheral resistance, ↓ BP -
Desired effects
• Decreased BP
Calcium Channel Blockers
• Exert a number of beneficial effects on the heart and Adverse effects
blood vessels by blocking calcium ion channels • Dizziness, weakness, drowsiness, headache, orthostatic hypotension, palpitations, chest pain, edema, dysrhythmias, nausea and vomit
• Widely used in the treatment of hypertension and other diarrhea, constipation, abdominal pain
cardiovascular diseases
Nursing implications
Calcium channel blockers: Nifedipine • Orthostatic hypotension

Indications for use β1- receptors in heart muscle cells

- Hypertension, angina, migraine prophylaxis adrenergic blockers (“olols”): Metoprolol

Indications for use

Mechanism of action
• Hypertension, angina, MI
• Acts by selectively blocking calcium channels in
myocardial and vascular smooth muscle, including that in
Mechanisms of Action
the coronary arteries
• Acts by selectively blocking the beta1 adrenergic β1- receptors in heart muscle cells
• ↓oxygenusebyheart,↑CO,↓BP
• ↓ BP, ↓ myocardial O2 demand, ↓ elevated renin plasma levels, -
receptor
Desired effect
• Decreased BP in hypertension
Desired effects
• Decreased BP, heart rate
Adverse effects
• Headache, dizziness, drowsiness, lightheadedness,
Adverse effects
dysrhythmias, nausea, vomiting, hypotension, tachycardia,
• Insomnia, dizziness, headaches, HF, palpitations, dysrhythmias, cardiac arrest, hypotension, bradycardia,
palpitations, diarrhea, constipation, nocturia, polyuria
pulmonary/peripheral edema, chest pain, nausea and vomiting, diarrhea, constipation hiccups,
bronchospasm, agranulocytosis, thrombocytopenia purpura
Nursing implications
• grapefruit juice, ECG, vital signs (BP & HR)

ACE inhibitors and angiotensin II receptor blockers

• blocks the renin - angiotensin aldosterone syndrome to prevent the intense vasoconstriction caused by angiotensin 2
• Decrease blood volume which enhances their antihypertensive effect

ACE inhibitors (“prils”): Enalapril

Indications for use

• Hypertension, HF, left ventricular dysfunction

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convert
Mechanisms of Action
• Inhibits angiotensin-converting enzyme (ACE) Prevents conversion of angiotensin I to angiotensin II resulting in dilation of
arterial and venous vessels Angiotensin II strong vasoconstrictor
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2
Desired effects
-
• Decreased BP in hypertension
1
Adverse effects
• Dizziness, headache, nausea and vomiting, dry cough, diarrhea, hypotension, chest pain, tachycardia, dysrhythmias, syncope, angina,
orthostatic hypotension, tinnitus, proteinuria, agranulocytosis, neutropenia, ↓ Na+ and ↑ K+ and ↑ Cr+

·
Angiotensin II receptor blockers (ARBs): Losartan -

S
Indications for use
• Hypertension, patients who cannot tolerate ACE inhibitors ARB BLOCKS
bind -2
Mechanism of Action
• Selectively blocks the binding of angiotensin II to the AT1 receptor found in tissues
Blocks the vasoconstricting and aldosterone- secreting effects of angiotensin II

of
Desired effects
• Decreased BP

Adverse effects
• Dizziness, insomnia, headache, hypotension, diarrhea, dyspepsia, constipation, dry mouth, thrombocytopenia angioedema,
cough, hyperkalemia, hypoglycemia