Thiazide Diuretics - Paper Example

Examples include hydrochlorothiazide (12.5 mg) daily, Chlorothalldone (25 mg) daily, and Metolazone (2.5 mg) daily.

Inhibit the reabsorption of sodium and chloride in the distal tubules. More so, they increase the excretion of potassium and bicarbonate as well as decrease the excretion of calcium and uric acid retention (Alexander, 2017). Monitor the renal function by looking at the potassium and serum creatinine levels (Alexander, 2017). Thiazide diuretics interact with lithium ions and digoxin (Zwieten, 2003).

Calcium Channel Blockers. Classified as dihydropyridines and non dihydropyridines. Examples of dihydropyridines include amlodipine, nifedipine, clevidipine, and felodipine. Non dihydropyridines include verapamil and diltiazem. Dihydropyridines bind to L-type calcium channels in the vascular smooth muscle and leads to vasodilatation and a decrease in blood pressure while non dihydropyridines bind to L-type calcium channels in the sinoatrial and atrioventricular node, and exerting effects in the myocardium and vasculature (Alexander, 2017). Blood tests are necessary when monitoring calcium channel blockers therapy. Calcium channel blockers interact with digoxin, beta blockers, protease inhibitors, and cimetidine (Zwieten, 2003).

ACE Inhibitors.

Examples include Fosinopril (5 mg) daily, Captopril (25 mg) daily, Ramipril (5mg) daily, Lisinopril (10 mg) daily, and Qulnaprill (20 mg) daily. ACE inhibitors prevent angiotensin I from converting to angiotensin II and block the major pathway of bradykinin degradation by inhibiting ACE (Alexander, 2017). Careful monitoring of serum potassium levels is necessary due to the increased risk of hyperkalemia when using the medications (Alexander, 2017). ACE interact with diuretics (thiazide), lithium ions, diuretics (K+ -sparing), and NSAIDS (Zwieten, 2003).

Angiotensin II Receptors Antagonists. Examples include Losartan (50mg) daily, valsartan (80 mg) daily, Olmesartan (20 mg) daily, Eprosartan (600 mg) daily, and Azllsartan (80 mg) daily. ARBs work by block binding angiotensin-II induced vasoconstriction, sodium retention, and the release of aldosterone Alexander, 2017). Just as ACE inhibitors, careful monitoring of serum potassium levels is necessary due to the increased risk of hyperkalemia when using the medications (Alexander, 2017). Angiotensin II Receptors Antagonists interact with diuretics (thiazide), lithium ions, diuretics (K+ -sparing), and NSAIDS (Zwieten, 2003).

Beta Blockers, Beta-1Selective. Examples include Atenolol (50 mg) daily, Metoprolol (100mg) daily, Propranolol (40 mg) twice daily, Timolol, and Bisoprolol. They block beta-1 receptors (Alexander, 2017). When dealing with patients who have asthma and severe chronic obstructive pulmonary disease, the nurse should monitor the patients blood pressure (Alexander, 2017) Beta blockers interact with verapamil diltiazem, oral antidiabetics, broncho-spasmolytic agents, and dobutamine (Zwieten, 2003).

2. High Cholesterol

Drug Class Mechanism of Action Test Used for Monitoring Drug Interactions

Statins. Examples include Lipitor, Lescol, Lovastatin, Livalo, Zocor, Crestor, and Pravachol. They lower triglycerides and raise the good cholesterol mildly (Beckerman, 2016). Monitor the lipid panel at the baseline immediately after commencing treatment. As well, monitoring side effects such as intestinal problems, liver damage (rare), and muscle inflammation is necessary (Beckerman, 2016). More so, liver enzymes should be monitored before and during treatment (Wiklund, Pirrazi, & Romeo, 2013). Moreover, the authors affirm that patients should be monitored for risk of developing diabetes. Statins interacts with grapefruit and grapefruit juice (Beckerman, 2016).

Niacins. Examples include Niaspan and Nicoar. It lowers LDL cholesterol and raises HDL cholesterol (Beckerman, 2016). Clinicians should monitor the blood glucose level with patients who have or are at risk of developing diabetes (Wiklund, Pirrazi, & Romeo, 2013). As well, side effects such as headaches, nausea, and dizziness. When taken with Satins, they lower the blood pressure further (Beckerman, 2016).

Bile Acid Resin. Examples include Colestipol, Cholestyramine, and Colesevelam. They attach to bile from the liver and prevent it from being absorbed back into the blood (Beckerman, 2016). Monitor the plasma lipid levels (Wiklund, Pirrazi, & Romeo, 2013). The medications interact with satins to increase the risk of heart events (Beckerman, 2016).

Fibrates. Examples include Fenofibrate and Lopid. The drugs reduce the levels of triglycerides the body makes and can boost your good HDL cholesterol (Beckerman, 2016). Take blood tests to monitor the presence of clots. The medications interact with statins, diabetes medications, and blood thinners.

PCSK9 Inhibitors. Examples include Praluent and Repatha. They block a protein called PCSK9 to allow room for the body to remove LDL from the blood (Alexander, 2016). Clinicians should monitor the injection sites to check for allergic reactions and infections. No known drug interactions.

Cholesterol Absorption Inhibitors. An example includes Zetia. The medication blocks the absorption of cholesterol from food and bile juices from an individuals intestines into their blood (Phan, Dayspring, & Toth, 2012). Clinicians should monitor patients who have moderate to severe renal impairment carefully. As well, they should take blood tests from the patient before commencing treatment and during treatment. May be used in combination with the other drugs for lowering cholesterol.

Omega- 3 Fatty Acids Supplements Lower serum triglyceride concentrations in the body. Blood tests are necessary because of the effect of acute illness of triglyceride levels. Can be combined with statins to achieve a maximum effect of lowering cholesterol levels in the body.

References

Alexander, M. R. (2017). Hypertension Medication. Medscape. Retrieved from

https://emedicine.medscape.com/article/241381-medication#11

Beckerman, J. (2016). Which Medicines Lower Bad (LDL) Cholesterol? WebMD. Retrieved

from https://www.webmd.com/cholesterol-management/guide/cholesterol-lowering-medication#2

Phan, B. A. P., Dayspring, T. D., & Toth, P. P. (2012). Ezetimibe therapy: mechanism of action

and clinical update. Vascular Health and Risk Management, 8, 415427.

Wiklund, O., Pirazzi, C., & Romeo, S. (2013). Monitoring of Lipids, Enzymes, and CreatineKinase in Patients on Lipid-Lowering Drug Therapy. Current Cardiology Reports, 15(9), 397.

Zwieten, P. A. (2003). Interactions between Antihypertensive Agents and other Drugs. European

Society of Hypertension Scientific Newsletter, vol. 4, no, 17.