study guides

Group 6: acebutolol, metoprolol, prazosin, captopril

PRAZOSIN

Trade names: Minipress

Indications: Mild to moderate hypertension, refractory CHF; treatment of BPH

Action: Blocks post-synaptic alpha-adrenergic receptors, dilating peripheral vessels; decreases contractions in smooth muscle of prostatic capsule

Contraindications: Renal disease, hypersensitivity

Precautions: pregnancy, lactation or angina pectoris

Side Effects: dizziness, drowsiness, headache, N/V, diarrhea, impotence, vertigo, urinary frequency, tinnitus, dry mouth, incontinence, abdominal discomfort

Adverse reactions: orthostatic hypotension, palpitations, tachycardia, pancreatitis

Interactions: increased hypotensive effect: other antihypertensives, nitrates, alcohol; decreased hypotensive effect: NSAIDs

Nursing Implications: Monitor I&O’s, and weight, and assess for edema daily.  Monitor BP and pulse frequently during initial drug dosage adjustment, and periodically throughout treatment.  For BPH: assess patient for urinary symptoms periodically.


ACEBUTOLOL HCL

(Sectral, Monitan)

Category: Beta 1 blocker, cardioselective beta-adrenergic antagonist, antihypertensives, antiarrhythmics.

Action: Drug blocks beta1-adrenergic receptors in the cardiac tissue

Therapeutic effects: decrease heart rate, decrease AV conduction, & decrease blood pressure.

Indication: treatment of ventricular dysrhythmias & hypertension. Unlabeled use:  angina pectoris, management of anxiety & tremors.

Side effect: Dizziness, nausea, headache, hypotension, diaphoresis, fatigue, weakness, constipation or diarrhea, occasionally impotence Adverse reactions: palpitations with abrupt withdrawal, bradycardia, CHF, pulmonary edema. Life threatening: agranulocytosis, bronchospasm with high dose

 

Nursing Implication: Monitor BP, ECG, pulse, I&O. Assess for S&S of CHF. Before administering the med, take apical pulse. If less than 50 bpm or arrhythmia occurs, withhold the med & notify MD. Nursing Education: teach pt how to take apical pulse & take the med exactly as directed, at the same time each day, do not miss or double dose.

 

 

David Drug guide 10 edition p. 84

Web: http://www.rxlist.com/sectral-drug.htm

CAPTOPRIL

Trade Name:  Capoten

Indications: Management of hypertension; Decreased progression of diabetic nephropathy.   

Action:  ACE inhibitors that blocks the conversion of angiotensin I to the vasoconstrictor angiotensin II.  Lowers BP and decreases after load in pts with CHF.

Pharmacokinetics:  (Absorption) 75% absorbed following oral administration (decreased by food).
(Distribution) Crosses the placenta; enters breast milk in small amounts.  (Metabolism and Excretion) 50% metabolized by the liver to inactive compounds, 50% excreted unchanged in urine

Contraindications/Precautions:  Hypersensitivity.  Cross sensitivity among ACE inhibitors may occur. 

Side Effects-Adverse Reactions:  Dizziness, fatigue, cough, hypotension, taste disturbances, proteinuria, agranulocytosis, neutropenia and angioedema.

Interactions:  Excessive hypotension, hyperkalemia, increases levels and may increase the risk of lithium toxicity.

Nursing Implications (assessment):   Monitor BP and pulse, monitor weight and asses for fluid overload, monitor BUN, creatine and electrolyte levels.

 



Implementation:  Precipitous drop in BP during the first 1 to 3 hr following first dose may require volume expansion with NS.  Administer 1 hr before meals.  Tablet may be crushed and tables may have a sulfurous odor.


METOPROLOL

Trade Name:  Betaloc, Betaloc Durules, Lopresor, Lopresor SR, Lopressor, Novometoprol, Toprol-XL

Classifications:

·        Therapeutic: antianginals, antihypertensives 

·        Pharmacologic: beta blockers

Indications:  Hypertension, Angina pectoris, Prevention of MI and decreased mortality in pts with MI

Action:  Decreases blood pressure and heart rate, attacks of angina pectoris and rate of cardiovascular mortality.


Pharmacokinetics:

·        Absorption: Well after oral administration

·        Distribution: crosses the blood-brain barrier

·        Metabolism and Excretion: Mostly metabolized by the liver

Contraindications/Precautions:  Uncompensated CHF, Pulmonary edema, Cardiogenic shock and Bradycardia or heart block

 

Side Effects-Adverse Reactions:  Fatigue, weakness, bradycardia, CHF, pulmonary edema and hypotension. 


Nursing Implications (assessment):   Monitor VS and ECG every 5 to 15 min during and after administration.  HR less than 40 bpm, especially if output is decreased, administer atropine.  Monitor intake and output and daily weights.  Asses for signs and symptoms of CHF. 

 

 


Implementation:  High Alert:  IV vasoactive medications are inherently dangerous.  Before administering intravenously, have a second practitioner independently check original orders and dose calculations.


QUESTIONS:

 

1)      Sectral can do the following:

a.       Lower BP

b.       Lower HR

c.       Management of angina pectoris

d.       All of the above

 

2)      What the nurse should do before administering Acebutolol?

a.       Measure the BP

b.       Count the pulse

c.       Take pt’s apical pulse to make sure it is greater than 50 bpm

d.      Measure I&O

 

3)     In addition to hypertension, prazosin is used to treat:

a.     Benevolent perineum hypotension

b.     Benign pericardial hypersensitivity

c.     Benign prostatic hyperplasia

d.     Blood pressure hyperplasia

          e.    All of the above

 

         4) The trade name for Captopril is

          a.     Capoten

          b.     Benazepril

          c.     Enalapril

          d.     Fosinopril

 

               5) What is NOT a side-effect of Captopril?

          a.     Fatigue

          b.     Cough

          c.     Hypertension

          d.     Dizziness

 

       6) When giving your patient Captopril what are two most important things you would assess?

          a.      Food intake and temperature

          b.      BP and weight

          c.      Pulse and bowel movements

          d.     BP and lung sounds

 

       7)  Captopril is prescribed for patients with?

            a.       Hypertension

            b.      Weight gain

            c.      Hypotension

            d.      None of the above

      8) Checking the weight of a pt who is taking Metoprolol is to monitor which side effect and cause?

a.   Weight gain due to eating too much?

b.   Weight gain due to pulmonary edema?

c.   Weight loss due to cardiac output?

d.   Weight loss due to dieting?

 

 

Answers: 1-d, 2-c, 3-c, 4-a, 5-c, 6-b, 7-a, 8-b

 

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Rachel Olney,
Nov 1, 2008, 4:31 PM
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