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