Category: Anti-Hypertensives

Direct Vasodilators – Anti-Hypertensives in Cardiovascular Pharmacology

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Here you can find videos related to direct vasodilators which are anti-hypertensive drugs covered within cardiovascular pharmacology…

Cardiovascular pharmacology deals with the study of the effects of drugs upon the heart or circulatory system. Cardiovascular medicines help to prevent and treat cardiovascular disease, slow the progression of it as well as treat its symptoms whilst providing a better quality of life and increasing life expectancy.

Types of Cardiovascular Drugs include:

  • Anti-Hypertensive Drugs
  • Anti-Angina Drugs
  • Anti-Arrhythmic Drugs
  • Anti-Coagulants
  • Anti-Hyperlipidaemic Drugs

Anti-Hypertensive Drugs are further sub-divided into 4 categories, namely:

Renin-Angiotensin Aldosterone Inhibitors

Adrenergic System Inhibitors

Diuretics

Direct Vasodilators

Below you can find a collection of videos that can help provide a more visual approach to cardiovascular pharmacology, specifically on the Anti-Hypertensive Drugs – Direct Vasodilators.

Nitrates

  • Available as sublingual spray, oral tablets, transdermal patch, and IV preparation.
  • Oral medication can be taken up to 3 times within 5 minute intervals; burning sensation may be experienced (harmless).
  • Sustained release formulas: do not crush and swallow whole; Injection sites should be switched continuously; taper dose over 4-6 weeks to prevent MI.
  • Transdermal patches can lead to patient tolerance. To avoid, remove patch for 4-8 hours, ideally during the night.
  • Nitrates are sensitive to light. Protect from sunlight.
  • INDICATIONS: angina, acute coronary syndrome, for reduction of chest pain and infarct size in MI.
  • ADVERSE EFFECTS: CNS – throbbing headache, dizziness, weakness; CV – hypotension, reflex tachycardia, syncope; GI – nausea, vomiting, incontinence; EENT – pallor, flushing, sweating; methemoglobinemia and cyanosis if administered in high doses.

Calcium Channel Blockers

Nifedipine, Amiodipine, Nicardipine – Dihyropyridines (Anti Hypertensive properties).

Diltaziem, Verapamil – Non-Dihydropyridines (Anti-Arrhythmic properties).

  • Causes a decrease in peripheral resistance, blood pressure and cardiac workload, as well as vasodilation.
  • INDICATIONS: angina pectoris, effort-associated angina, chronic stable angina, unstable crescendo preinfarction angina, essential hypertension.
  • Parenteral administration for treatment of supraventricular tachyarrhythmia, and temporary control of rapid ventricular rate in atrial flutter or atrial fibrillation.
  • ADVERSE EFFECTS: dizziness, light-headedness, headache, fatigue, hypotension, heart block, peripheral oedema, bradycardia, nausea, skin flushing, rash.

Direct Vasodilators: Nitroglycerin and Angina

Direct Vasodilators: Administering Nitroglycerin Sublingual Tablets and Translingual Spray

Calcium Channel Blockers

Special thanks to the creators of the featured videos on this post, specifically Youtube Channels Simple Nursing and Registered Nurse RN

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Diuretics – Anti-Hypertensives in Cardiovascular Pharmacology

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Here you can find videos featuring Diuretics through a visual approach to anti-hypertensive drugs for Cardiovascular Pharmacology use

Cardiovascular pharmacology deals with the study of the effects of drugs upon the heart or circulatory system. Cardiovascular medicines help to prevent and treat cardiovascular disease, slow the progression of it as well as treat its symptoms whilst providing a better quality of life and increasing life expectancy.

Types of Cardiovascular Drugs include:

  • Anti-Hypertensive Drugs
  • Anti-Angina Drugs
  • Anti-Arrhythmic Drugs
  • Anti-Coagulants
  • Anti-Hyperlipidaemic Drugs

Anti-Hypertensive Drugs are further sub-divided into 4 categories, namely:

Renin-Angiotensin Aldosterone Inhibitors

Adrenergic System Inhibitors

Diuretics

Direct Vasodilators

Below you can find a collection of videos that can help provide a more visual approach to cardiovascular pharmacology, specifically on the Anti-Hypertensive Drugs – Diuretics

Diuretics: Promote the production of urine, thus increasing urine volume and the excretion of water from the body.

Before starting patient on diuretics, take baseline data of fluid and electrolyte disturbances, hepatorenal diseases, glucose tolerance abnormalities; Assess skin for oedema and skin tugor status; Assess cardiopulmonary status (blood pressure, pulse, heart and lung sounds); Measure body weight to monitor fluid loss or retention.

Monitor intake and output of voiding; monitor lab tests especially K+, Ca+ uric acid and glucose levels; monitor LFTs and renal function.

ADVERSE EFFECTS: electrolyte imbalance, hyperglycaemia, hyperuricemia, acid base disturbances.

Thiazide Diuretics: Bendroflumethazide, Hydrochlorthiazide, Indapamide

  • Most commonly used diuretic.
  • Milder effect when compared to loop diuretics.
  • Causes lower peripheral vascular resistance as well as the excretion of sodium, water, chloride and potassium.
  • INDICATIONS: pulmonary oedema, forced diuresis.

Loop: Bumetanide, Furosemide

  • Causes greatest possible amount of diuresis.
  • Bumetanide is 40% more potent in producing rapid diuresis.
  • Available in oral, IV and IM formulation.
  • INDICATIONS: hypertension, heart failure, oedema.

Potassium Sparing: Spironolactone, Amiloride.

  • Stops sodium reabsorption by interfering with the sodium potassium pump in the distal convoluted tubule.
  • Used along with Thiazides or Loops when increased diuretic effect is desired.
  • INDICATIONS: ideal for patients with low potassium level (hypokalaemia).

Thiazide Diuretics

Loop Diuretics

Potassium Sparing Diuretics

Special thanks to the creator of the featured videos on this post, specifically Youtube Channel Registered Nurse RN

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Adrenergic System Inhibitors – Anti-Hypertensives in CV Pharmacology

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Adrenergic System Inhibitors features videos that provide a visual approach to alpha and beta blockers in cardiovascular pharmacology.

Cardiovascular pharmacology deals with the study of the effects of drugs upon the heart or circulatory system. Cardiovascular medicines help to prevent and treat cardiovascular disease, slow the progression of it as well as treat its symptoms whilst providing a better quality of life and increasing life expectancy.

Types of Cardiovascular Drugs include:

  • Anti-Hypertensive Drugs
  • Anti-Angina Drugs
  • Anti-Arrhythmic Drugs
  • Anti-Coagulants
  • Anti-Hyperlipidaemic Drugs

Anti-Hypertensive Drugs are further sub-divided into 4 categories, namely:

Renin-Angiotensin Aldosterone Inhibitors

Adrenergic System Inhibitors

Diuretics

Direct Vasodilators

Below you can find a collection of videos that can help provide a more visual approach to cardiovascular pharmacology, specifically on the Anti-Hypertensive Drugs – Adregenic System Inhibitors.

The Adrenergic System:

The main neurotransmitter of the Adrenergic system is Nonepinephrine. Nonepinephrine acts on all adrenergic receptors to generate a response.

When the sympathetic system is stimulated, there is an increase in heart rate and contractility, and blood vessels constrict. When the sympathetic system is blocked, the heart rate slows down and the blood vessels dilate.

Drugs that STIMULATE the adrenergic system = alpha or beta agonists (sympathomimetics).

Drugs that BLOCK the adrenergic system = alpha or beta blockers (sympatholytics).

Beta Blockers:

Beta Blockers block action of Epinephrine and Nonepinephrine and act as antagonists, blocking beta1 (heart) and beta2 (lungs) adrenergic receptors.

First Generation Nonselective Beta Blockers – Act on B1 (Heart) & B2 (Lungs) eg. Nadolol, Oxprenolol, Penbotalol, Pindolol, Propanolol, Sotalol, Timolol.

Second Generation B1 Selective Beta Blockers – Act on B1 (Heart) eg. Acebutolol, Atenolol, Bisoprolol, Esmolol, Metoprolol. Ideal for asthmatics!

Third Generation Vasodilatory: Nonselective eg. Carteolol, Carvedilol, Labetalol; B1 Selective eg. Betaxolol, Nebivolol.

  • INDICATIONS: angina, arrhythmias, heart failure, hypertension, MI.
  • ADVERSE EFFECTS: bradycardia, hypotension, increase in lipidemia, decrease in libido, bronchospasm causing shortness of breath, chronic heart failure due to abnormalities in conductivity, kinks peripheral vessels, exhaustion, emotional depression, masks hyperglycaemia.
  • CONTRAINDICATIONS: bradycardia, heart block, asthma (do not administer 1st Gen Beta Blockers especially Propanolol), CHF, diabetes, COPD. Avoid concurrent administration of BB with CCBs and Diuretics.
  • NURSING INTERVENTION: check pulse and do not administer if patient is bradycardic. Be extremely careful with HF patients. Monitor side effects.
  • PATIENT EDUCATION: advise not to stop medication abruptly. Take with food to reduce or prevent GI disturbances. Whilst body adjusts to medication, side effects such as dizziness, light headedness, drowsiness and blurred vision may occur. Cold extremities may be due to the reduction of blood circulation to the extremities.

Alpha Blockers:

Alpha Blockers eg. Doxasozin, Prasozin.

Alpha 1 causes blood vessels to dilate = reduction in the peripheral resistance = fall in BP = postural hypotension. Decreases contraction force of the heart.

Alpha 2 causes vascular smooth muscles to dilate = decrease in BP.

The Sympathetic vs Parasympathetic Nervous System: Inhibiting and Stimulating Drugs

Beta Blockers

Alpha Blockers

Special thanks to the creators of the featured videos on this post, specifically Youtube Channels Registered Nurse RN and Drugs in Motion.

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RAAS Renin-Angiotensin Aldosterone System: CV Drugs Affecting RAAS

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This post features a collection of videos that provide a visual approach on cardiovascular pharmacology for student nurses, specifically on anti-hypertensives affecting RAAS.

Cardiovascular pharmacology deals with the study of the effects of drugs upon the heart or circulatory system. Cardiovascular medicines help to prevent and treat cardiovascular disease, slow the progression of it as well as treat its symptoms whilst providing a better quality of life and increasing life expectancy.

Types of Cardiovascular Drugs include:

  • Anti-Hypertensive Drugs
  • Anti-Angina Drugs
  • Anti-Arrhythmic Drugs
  • Anti-Coagulants
  • Anti-Hyperlipidaemic Drugs

Anti-Hypertensive Drugs are further sub-divided into 4 categories, namely:

Renin-Angiotensin Aldosterone Inhibitors

Adregenic System Inhibitors

Diuretics

Direct Vasodilators

Below you can find a collection of videos that can help provide a more visual approach to cardiovascular pharmacology, specifically on the Anti-Hypertensive Drugs – Renin-Angiotensin Aldosterone Inhibitors RAAS.

RAAS – Renin-Angiotensin Aldosterone System

The RAAS system regulates the blood volume and the systemic vascular resistance, affecting the cardiac output (bloodflow) and arterial pressure, and impacting Renin, Angiotensin and Aldosterone.

ACE Inhibitors:

ACE inhibitors end with _pril eg. Enalapril, Lisinopril, Perindopril.

  • Block the conversion of Angiotensin 1 to Angiotensin 2 = decrease in BP, peripheral volume, heart workload, blood volume, aldosterone secretion.
  • INDICATIONS: hypertension, heart failure, left ventricular hypertrophy.
  • SIDE EFFECTS: headache, dizziness, tiredness, hypotension (especially after 1st dose; ideally administer before going to bed at night), reflex tachycardia, arrhythmias, decreased renal function, dry persistent non-productive cough, angioedema (breathing problems), rash, taste disturbances, hyperkalaemia.
  • NURSING INTERVENTION: avoid abrupt stopping of medication, take 1hr before or 2hrs after a meal, monitor patients with risk of dehydration, check blood profile for electrolytes and creatinine, monitor BP, avoid NSAIDs to minimise renal damage risk, stop additional K+ sparing diuretics and K+ supplements as they would increase the risk for hyperkalaemia.

ARBs – Angiotensin II Receptor Blockers:

ARBs end with _sartans eg. Candesartan, Losartan, Eprosartan.

  • Block Angiotensin II from binding with receptors in the smooth muscles of the heart and blood vessels = reduction in vasoconstriction, aldosterone secretion, catecholamine release, cell growth and BP.
  • No effect on bradykinin thus no non-productive cough is experienced as a side effect.
  • INDICATIONS: hypertension, HF, LVF (left ventricular failure), patients unable to take ACE inhibitors eg. those experiencing dry cough.
  • ADVERSE EFFECTS: headache, dizziness, weakness, orthostatic hypotension, URTI (upper respiratory tract infections), mild cough, diarrhoea, abdominal pain, nausea, dry mouth, tooth pain, rash, alopecia, dry skin.

Renin Angiotensin Aldosterone System (RAAS)

ACE Inhibitors

Angiotensin II Receptor Blockers ARBs

Special thanks to the creator of the featured videos on this post, specifically Youtube Channel Registered Nurse RN.

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