CHAPTER 43

Focus On Nursing Pharmacology

Drugs Affecting Blood Pressure

 CATEGORIES RATING THE SEVERITY OF HYPERTENSION

BP Range
Category
Systolic Pressure Diastolic Pressure
<130 mm Hg <85 mm Hg Normal blood pressure
130–139 85–89 High normal blood
pressure
140–159 90–99 Stage 1 (mild)
hypertension
160–179 100–109 Stage 2 (moderate)
hypertension
180–209 110–119 Stage 3 (severe)
hypertension
>210 >120 Stage 4 (very severe)
hypertension
 Antihypertensions
• Diuretics
• Beta blockers
• Alpha and beta blockers
• Alpha adrenergic blockers
• Alpha1 blockers
• Alpha2 agonists
Angiotensin-Converting Enzyme
Inhibitors (ACE)
• Prevent angiotensin-converting enzymes from
converting angiotensin I to angiotensin II, a
powerful vasoconstrictor and stimulator of
aldosterone release, leading to a decrease in
blood pressure and in aldosterone secretion
with a resultant slight increase in serum
potassium and a loss of serum sodium and fluid
• Indicated for the treatment of hypertension,
alone or in combination with other drugs
Angiotensin II Receptor Blockers
(ARB)

• Selectively bind with angiotensin II receptor

sites in vascular smooth muscle and in the
adrenal gland to block vasoconstriction and
the release of aldosterone
• Indicated to be used alone or in combination
therapy for the treatment of hypertension
 Calcium Channel Blockers
• Inhibit the movement of calcium ions across
the membranes of myocardial and arterial
muscle cells, altering the action potential
and blocking muscle cell contraction;
depressing myocardial contractility, slowing
cardiac impulse formation in the conductive
tissues, and relaxing and dilating arteries,
causing a fall in blood pressure and a
decrease in venous return
• Indicated for treatment of hypertension and
angina
 Vasodilators
• Act directly on vascular smooth muscle to
cause muscle relaxation, leading to
vasodilation and drop in blood pressure
• Indicated for the treatment of severe
hypertension that has not responded to other
therapy
 Antihypotensive Agents

• Sympathetic adrenergic agonists

• Midodrine- α1-receptor agonist