12/04/2025
Hypertension (high blood pressure) is a chronic medical condition where the blood pressure in the arteries is persistently elevated. Antihypertensive drugs are medications used to lower and control blood pressure to prevent complications such as stroke, heart attack, and kidney damage.
Classification of Antihypertensive Drugs
1. Diuretics
Example: Hydrochlorothiazide, Furosemide
Mechanism: Increase urine output, reducing blood volume and pressure.
Side Effects: Dehydration, electrolyte imbalance (e.g., hypokalemia)
Nursing Considerations: Monitor electrolytes, encourage fluid intake, monitor weight and blood pressure.
2. Beta-Blockers
Example: Atenolol, Metoprolol, Propranolol
Mechanism: Decrease heart rate and cardiac output
Side Effects: Bradycardia, fatigue, cold extremities
Nursing Considerations: Check pulse before administration, monitor for signs of heart failure
3. Calcium Channel Blockers (CCBs)
Example: Amlodipine, Nifedipine, Verapamil
Mechanism: Relax blood vessels by blocking calcium entry into smooth muscles
Side Effects: Swelling (edema), headache, dizziness
Nursing Considerations: Monitor blood pressure, check for swelling, educate about orthostatic hypotension
4. ACE Inhibitors (Angiotensin-Converting Enzyme Inhibitors)
Example: Lisinopril, Enalapril
Mechanism: Inhibit the formation of angiotensin II, reducing vasoconstriction
Side Effects: Dry cough, hyperkalemia, hypotension
Nursing Considerations: Monitor potassium levels, educate patient about dry cough
5. ARBs (Angiotensin II Receptor Blockers)
Example: Losartan, Valsartan
Mechanism: Block angiotensin II receptors, causing vasodilation
Side Effects: Dizziness, increased potassium levels
Nursing Considerations: Alternative to ACE inhibitors if cough develops
6. Alpha Blockers
Example: Prazosin, Doxazosin
Mechanism: Relax blood vessels by blocking alpha-adrenergic receptors
Side Effects: First-dose hypotension, dizziness
Nursing Considerations: Give first dose at bedtime, monitor for falls
7. Centrally Acting Agents
Example: Methyldopa, Clonidine
Mechanism: Reduce sympathetic outflow from the brain
Side Effects: Sedation, dry mouth
Nursing Considerations: Monitor mental alertness, avoid abrupt withdrawal
8. Vasodilators
Example: Hydralazine, Minoxidil
Mechanism: Directly relax arteriolar smooth muscle
Side Effects: Reflex tachycardia, fluid retention
Nursing Considerations: Often used in combination with diuretics
General Nursing Responsibilities in
Antihypertensive Therapy
1. Monitor blood pressure regularly.
2. Educate the patient on lifestyle modification.
3. Monitor for adverse drug reactions.
4. Encourage medication adherence.
5. Teach patients to rise slowly to avoid orthostatic hypotension.
