NCM 106

PHARMACOLOGY
GROUP 13
BSN – 2B
TOPIC OUTLINE:

DRUGS ACTING ON THE CARDIOVASCULAR SYSTEM

 Antihypertensive Drugs
 Cardiotonic Agents
 CARDIOVASCULAR SYSTEM
• Responsible for delivering oxygen and nutrients to all of the cells of
the body and for removing waste products for excretion.
• The heart is a hollow muscle with four chambers comprising two atria
and two lower ventricles, pumps oxygenated blood to the body’s cells
and also collects waste products from the tissues.
• Arrythmias is a disruption in cardiac rate or rhythm. Also called as
Dysrhythmia.
DRUGS AFFECTING BLOOD PRESSURE
ANTIHYPERTENSIVE AGENTS
Antihypertensives are a class of drugs that are used to treat hypertension (high
blood pressure)
I. Angiotensin-Converting Enzymes (ACE) Inhibitors
II. Angiotensin II – Receptor Blockers
III. Calcium Channel Blockers
IV. Vasodilators
 ANGIOTENSIN-
CONVERTING
ENZYMES (ACE)
INHIBITORS
• Acts in the lungs to prevent ACE from converting angiotensin I to
angiotensin II, a powerful vasoconstrictor and stimulator of
aldosterone release.
• Administered alone or with other drugs.
• Contraindications: Allergy, Impaired Renal Function
 ANGIOTENSIN-CONVERTING ENZYMES (ACE)
INHIBITORS
DRUG NAME CAPTOPRIL
INDICATIONS Treatment of Hypertension, Left Ventricular
Dysfunction after an MI.
ACTIONS Blocks, ACE from converting angiotensin I to
angiotensin II
CONTRAINDICATIONS Contraindicated in patients hypertensive to drug or
other ACE Inhibitors.
ADVERSE REACTIONS Abdominal Pain, Anorexia, Dizziness, Fainting,
Headache, Dyspnea, Urticarial Rash
NURSING CONSIDERATIONS Monitor patients blood pressure and pulse rate
frequently.
Alert: Elderly patients may be more sensitive to drug’s
hypotensive effects
Patient Teaching Tell the patient to use caution in hot weather and
during exercise.
ANGIOTENSIN II – RECEPTOR
BLOCKERS (ARB’s)
• These actions block the blood pressure-raising effects of the renin-
angiotensin system and lower blood pressure.
ANGIOTENSIN II – RECEPTOR
BLOCKERS (ARB’s)
DRUG NAME TELMISARTAN
CONTRAINDICATIONS Hypersentivity to the active substance or to any of the
excipients. OB: can cause injury or death of fetus
Lactation: Disontinue drug or provide formula
INDICATIONS It is used in the management of hypertension,
particularly in patients who develop cough with ACE
inhibitors and to reduce the risk of stroke in patients
with left ventricular hypertrophy, and in the treatment
of diabetic nephropathy
ADVERSE EFFECTS CNS: Dizziness, Anxiety, Depression, Fatigue,
headache, insomia, weakness.
CV: Hypotension, chest pain,
DERM: rashes
 ANGIOTENSIN II – RECEPTOR
BLOCKERS
DRUG NAME
(ARB’s) TELMISARTAN
PATIENT TEACHING - Instruct patient to notify health care professional of
medication if swelling of face, eyes, lips or tongue
occurs, or if difficulty swallowing or breathing occurs.
- Instruct patient to notify health care professional of
medication if swelling of face, eyes, lips or tongue
occurs
- May cause dizziness. Caution patient to avoid driving
or other activities requiring alertness until response to
medication is known.

NURSING CONSIDERATION Monitor patient for hypotension after starting the

drug.
CALCIUM CHANNEL BLOCKERS
• Decrease blood pressure, cardiac workload,
and myocardial oxygen consumption.
 CALCIUM CHANNEL BLOCKERS
DRUG NAME DILTIAZEM
INDICATIONS Treatment of essential hypertension in the extended-
release form.
ACTIONS Inhibits the movement of calcium ions across the
membranes of cardiac and arterial muscle cells,
decreased myocardial contractility.
CONTRAINDICATIONS - Contraindicated in patients hypertensive to drug.
- Used cautiously in elderly patients.
ADVERSE REACTIONS Dizziness, Headache, Bradycardia, and nausea.
NURSING CONSIDERATIONS - If the systolic blood pressure is below 90 mmHg or
heart rate is below 60bpm notify the prescriber.
Patient Teaching - Tell the patient to take medication as prescribed.
- Tell the patient to swallow extended released
capsules whole do not crush them.
 VASODILATORS
• When other drug therapies do not achieve the desired reduction in
blood pressure, the use of direct vasodilators are done. Mostly
reserve in severe hypertension or hypertensive emergencies.
 VASODILATORS
DRUG NAME HYDRALAZINE
INDICATIONS Essential hypertension to lower blood pressure
ACTIONS Inhibits the movement of calcium ions across the
membranes of cardiac and arterial muscle cells,
decreased myocardial contractility.
CONTRAINDICATIONS - Contraindicated to patients hypertensive to drug
- In patients with suspected cardiac disease, stroke,
severe renal impairment
ADVERSE REACTIONS - nausea and vomiting, diarrhea, headache, dizziness,
rash
NURSING CONSIDERATIONS - Monitor the blood pressure , pulse rate and body
weight
- Monitor patient for signs of lupuslike syndrome
(fever, muscle and joint ache)
Patient Teaching - Tell the patient to notify prescriber of unexplained
prolonged general tiredness or fever, muscle ache.
- Tell patient that low blood pressure and dizziness
upon standing can be minimized by rising slowly.
 CARDIOTONIC AGENTS
 Cardiotonic agents, also known as inotropic agents, are medications that affect the strength and
force of the heart's contractions. They are commonly used in the management of heart failure and
certain cardiac arrhythmias, aiming to improve the heart's pumping ability and overall cardiac
function.

 Cardiac Glycosides
 Phosphodiesterase Inhibitors
 CARDIAC GLYCOSIDES
• Were originally derived from the foxglove or digitalis plant. Today,
Digoxin is the drug used to treat heart failure.
 CARDIAC GLYCOSIDES
DRUG NAME DIGOXIN
INDICATIONS Digoxin is used to treat heart failure, atrial fibrillation,
and atrial flutter. It helps the heart beat stronger and
slower, improving symptoms and quality of life in
heart failure patients.
CONTRAINDICATIONS - Digoxin should not be used in patients with
ventricular fibrillation, ventricular tachycardia, or
hypersensitivity to the drug.
ADVERSE REACTIONS Common adverse effects include nausea, vomiting,
loss of appetite, and visual disturbances. Serious side
effects like arrhythmias and electrolyte imbalances
can also occur.
 CARDIAC GLYCOSIDES
DRUG NAME DIGOXIN
NURSING CONSIDERATIONS - Nurses should assess the patient's vital signs,
especially heart rate and rhythm, before administering
digoxin. Monitoring electrolyte levels, particularly
potassium, is crucial, as hypokalemia can increase the
risk of digoxin toxicity.
- Nurses should also educate patients about
maintaining a consistent diet, especially regarding
potassium intake, as sudden dietary changes can
affect drug levels.
PATIENT TEACHING - Patients should be educated about the importance of
taking the medication as prescribed, understanding
signs of toxicity (such as nausea, vomiting, and
changes in vision), and regular follow-up
appointments for blood tests to monitor drug levels.
PHOSPHODIESTERASE INHIBITORS
• They belong to second class drugs that act as cardiotonic agents.
 PHOSPHODIESTERASE INHIBITORS
DRUG NAME INAMRINONE LACTATE
INDICATIONS Short term management of heart failure
ACTIONS Inhibits the movement of calcium ions across the
membranes of cardiac and arterial muscle cells,
decreased myocardial contractility.
CONTRAINDICATIONS - Use cautiously to patient with hypertrophic
cardiomyopathy
ADVERSE REACTIONS - Fever, hypotension, chest pain, nausea, vomiting
NURSING CONSIDERATIONS - Assess cardiac status closely including pulse and
blood pressure
- Protect drug from light to prevent drug degredation
- Monitor I & O
Patient Teaching - Tell the patient to notify prescriber of unexplained
prolonged general tiredness or fever, muscle ache.
- Tell patient that low blood pressure and dizziness
upon standing can be minimized by rising slowly.
REPORTERS:
• Lanz Andrie Caballero
• Marvelous Grace Camilote
• Cyrelle Joy Canabuan
• Christian Vher Chua
• Bai Jehan Dalandang
• Ariff Shadi L. Datumanong
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