Study Guide for NR 293 Exam 3
• Alpha2-adrenergic receptor stimulators (agonists)/clonidine
o Stimulate alpha2-adrenergic receptors in the
... [Show More] brain
o Decrease sympathetic outflow from the CNS, decrease norepinephrine production
o Stimulates alpha2-adrenergi receptors, thus reducing renin
o Examples: Clonidine (Catapres), Methyldopa (aldomet): used for pregnant women w/htn
• Alpha1-blockers/”azosin,”
o Block alpha1-adrenergic receptors
o Management of severe heart failure (HF) when used with cardiac glycosides and diuretics
o Some used to relieve symptoms of BPH- increase urinary flow rate
o Example: “ Azosin” (doxazosin (Cardura)
o Adverse Effects:
Serious: hypotension (first dose) syncope
Common: dizziness
o Nursing implications: instruct pt. to lie down after taking first dose because they may become dizzy
• Beta-blockers “olol”: First-line treatment for heart failure & HTN
o Reduce BP by reducing heart rate through beta1 blockade (block receptors for norepinhrine)
o Cause reduced secretion of renin
o Long-term use causes reduced peripheral vascular resistance
o Adverse Effects: orthostatic hypotension, bradycardia w/ reflex tachycardia, sexual dysfunction in men, possible hypoglycemia or hyperglycemia
• Angiotensin-converting enzyme inhibitor, “pril” Captopril
o Mechanism of Action:
Inhibit angiotensin-converting enzyme, which is responsible for converting angiotensin I (through the action of renin) to angiotensin II
Angiotensin II is a potent vasoconstrictor and causes aldosterone secretion from the adrenal glands
Result in decreased systemic vascular resistance (afterload), vasodilation, and therefore decreased blood pressure
o Indications:
First-line treatment for heart failure & HTN
HF (either alone or in combination with diuretics or other drugs)
Slow progression of left ventricular hypertrophy after MI (cardio protective)
Renal protective effects in patients with diabetes
Captopril and lisinopril can be used if a patient has liver dysfunction, unlike other ACE inhibitors that are pro-drugs
• *Pro-drugs are inactive in their administered form and must be metabolized in the liver to an active form so as to be effective
o Adverse Effects: hyperkalemia & dry, nonproductive cough
o Serious drug interaction: NSAIDs
• Angiotensin II receptor blocker “sartan” losartan (Dovan)
o Mechanism of Action:
Allow angiotensin I to be converted to angiotensin II, but block the receptors that receive angiotensin II
Block vasoconstriction and release of aldosterone
Well tolerated, do not cause a dry cough
Indications: first-line treatment for heart failure & HTN
o Adverse Effects: URI, headache
May cause occasional dizziness, inability to sleep, diarrhea
• Calcium channel blockers: Amlodipine “dipine” verapamil (calan), diltiazem (cardizem)
o Mechanism of Action: cause smooth muscle relaxation by blocking the binding of calcium to its receptors, preventing muscle contraction
o Adverse effect: constipation
High-fiber diet with plenty of fluids will help prevent constipation
o Indications: hypertension
Angina- ch. 23
• Ischemia:
o Ischemic heart disease: Poor blood supply to the heart muscle (Atherosclerosis, Coronary artery disease)
o Myocardial infarction (MI): Necrosis, or death, of cardiac tissue, disabling or fatal [Show Less]