I’m working on a health & medical discussion question and need the explanation and answer to help me learn.
The advanced practice nurse is updating the plan of care of nursing home patients with hypertension.
Briefly describe the therapeutic actions of drugs affecting blood pressure (diuretics, ACE inhibitors, ARBs, CCB, sympathetic nervous system drugs).
What important teaching points should be addressed for patients receiving antihypertensive drugs?
How to solve
St Thomas University Competing W Digital Discussion
Introduction:
In this response, we will discuss the therapeutic actions of drugs commonly used to manage hypertension, including diuretics, ACE inhibitors, ARBs, CCBs, and sympathetic nervous system drugs. We will also explore the important teaching points that should be addressed for patients receiving antihypertensive drugs.
Answer:
1. Therapeutic actions of drugs affecting blood pressure:
a) Diuretics: Diuretics promote the excretion of sodium and water from the body, leading to decreased blood volume and subsequently reduced blood pressure. By inhibiting the reabsorption of sodium in the renal tubules, diuretics increase the excretion of sodium and water in urine, which helps to reduce fluid accumulation and lower blood pressure.
b) ACE inhibitors (Angiotensin-Converting Enzyme inhibitors): ACE inhibitors block the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. By inhibiting this conversion, these drugs decrease the systemic vascular resistance, leading to vasodilation and subsequently lowering blood pressure.
c) ARBs (Angiotensin II Receptor Blockers): ARBs selectively block the binding of angiotensin II to its receptors, thereby preventing its vasoconstrictor effect on blood vessels. This action results in vasodilation and a subsequent decrease in blood pressure.
d) CCBs (Calcium Channel Blockers): CCBs inhibit the influx of calcium ions into cardiac and vascular smooth muscle cells. This blockade of calcium channels leads to relaxation of the arterial smooth muscles and dilation of blood vessels, resulting in decreased peripheral resistance and lowered blood pressure.
e) Sympathetic Nervous System Drugs: Sympathetic nervous system drugs, such as beta-blockers and alpha-blockers, act by modifying the effects of sympathetic neurotransmitters, such as norepinephrine. Beta-blockers block the beta receptors, reducing the amount of norepinephrine binding and ultimately decreasing cardiac output and peripheral resistance, resulting in lowered blood pressure. Alpha-blockers target alpha receptors, causing smooth muscle relaxation and vasodilation, leading to decreased blood pressure.
2. Important teaching points for patients receiving antihypertensive drugs:
a) Adherence to the prescribed medication regimen: Patients should be educated about the importance of taking their medications as prescribed, including the correct dosage and timing. Non-adherence can lead to fluctuations in blood pressure and ineffective management of hypertension.
b) Understanding potential side effects: Patients should be informed about the possible side effects associated with antihypertensive drugs. This knowledge will help them recognize and report any adverse reactions promptly.
c) Lifestyle modifications: Patients should be encouraged to adopt a healthy lifestyle, including regular exercise, a balanced diet, weight management, limited alcohol consumption, and smoking cessation. These modifications can complement medication therapy in managing hypertension effectively.
d) Regular monitoring of blood pressure: Patients should be advised to monitor their blood pressure regularly using home blood pressure monitoring devices. This practice enables patients to keep track of their progress and report any significant changes to their healthcare provider.
e) Importance of follow-up appointments: Patients should understand the importance of attending regular check-ups with their healthcare provider to monitor their blood pressure, adjust medication dosages if necessary, and evaluate the overall effectiveness of the treatment plan.
Conclusion:
Understanding the therapeutic actions of different antihypertensive drugs and addressing important teaching points can optimize patient care and improve outcomes in managing hypertension. Healthcare providers must provide comprehensive education to patients to ensure their active involvement in their treatment and the promotion of long-term blood pressure control.
