Medication Study Guide

ACE Inhibitors

AttributeDetail
Suffix -pril
Examples Enalapril (Vasotec)
Lisinopril (Zestril)
Ramipril (Altace)
Mechanism of Action Inhibits conversion of Angiotensin I to Angiotensin II, preventing vasoconstriction and water/sodium retention, leading to decreased blood pressure
Uses/Indications Hypertension
Heart failure
Myocardial infarction
Side Effects Dry cough
Angioedema
Hyperkalemia
Dizziness
Hypotension
Contraindications/Precautions Contraindicated in pregnancy (teratogenic). High risk of hyperkalemia (especially with K‑sparing diuretics). Avoid high‑potassium foods/salt substitutes.
Nursing Interventions Monitor blood pressure and heart rate. Do not abruptly discontinue—can cause rebound hypertension. Report any swelling immediately.
Patient Education Avoid potassium‑rich foods (bananas, spinach, oranges, tomatoes, potatoes, fish).
Notify provider if dry cough develops.

ARBs

AttributeDetail
Suffix -sartan
Examples Losartan (Cozaar)
Valsartan (Diovan)
Olmesartan (Benicar)
Mechanism of Action Inhibits Angiotensin II from binding to its receptors, preventing vasoconstriction and water/sodium retention
Uses/Indications Hypertension
Heart failure
Myocardial infarction
Side Effects Hyperkalemia
Angioedema (less common)
Dizziness
Hypotension
Contraindications/Precautions Contraindicated in pregnancy. Risk of hyperkalemia when used with potassium‑sparing diuretics.
Nursing Interventions Monitor BP and electrolytes. Avoid potassium‑rich foods and salt substitutes.
Patient Education May be used if ACE inhibitors are not tolerated due to cough. Continue monitoring for swelling or dizziness.

Aldosterone Antagonists

AttributeDetail
Suffix None standardized
Examples Spironolactone
Mechanism of Action Blocks aldosterone, leading to excretion of sodium and water. Does NOT excrete potassium (aka “potassium‑sparing”)
Uses/Indications Hypertension
Heart failure
Nephrotic syndrome
Hyperaldosteronism
Liver disease
Side Effects Hyperkalemia
Hyponatremia
GI upset
Amenorrhea
Gynecomastia
Erectile dysfunction
Contraindications/Precautions Avoid potassium‑rich foods/salt substitutes. Monitor for muscle cramps, dysrhythmias, or peaked T waves.
Nursing Interventions Monitor BP, daily weights, and serum potassium
Patient Education Report signs of hyperkalemia. Take at the same time daily.

Calcium Channel Blockers (CCBs)

AttributeDetail
Suffix -dipine (also -zem, -mil)
Examples Amlodipine
Nicardipine
Verapamil
Diltiazem
Mechanism of Action Prevents calcium from entering cardiac/vascular smooth muscle cells, causing relaxation, ↓HR, vasodilation
Uses/Indications Hypertensive crisis
Angina
Side Effects Headache
Flushing
Orthostatic hypotension
Constipation (Verapamil)
Peripheral edema
Gingival hyperplasia (-pine)
Contraindications/Precautions Avoid grapefruit juice. Contraindicated in heart block.
Nursing Interventions Check BP/HR before giving. Hold if HR <60 or SBP <100. Encourage high‑fiber diet.
Patient Education Rise slowly to avoid dizziness. Report significant swelling or bradycardia.

Beta Blockers

AttributeDetail
Suffix -olol
Examples Metoprolol, Atenolol, Esmolol (selective); Propranolol, Labetalol, Carvedilol (non‑selective)
Mechanism of Action Inhibits beta‑adrenergic receptors, reducing HR, myocardial contractility, and workload
Uses/Indications Hypertension
Stable angina
Heart failure (chronic)
Myocardial infarction
Dysrhythmias
Glaucoma (Timolol)
Side Effects Bradycardia
Hypotension
Hypoglycemia
Bronchospasm (non‑selective)
Dizziness
Weight gain
Edema
Contraindications/Precautions Contraindicated in asthma/COPD (non‑selective). Diabetics must monitor masked hypoglycemia.
Nursing Interventions Monitor BP/HR. Do not abruptly stop—can cause rebound hypertension.
Patient Education Change positions slowly. Monitor blood glucose if diabetic.

Alpha‑1 Blockers

AttributeDetail
Suffix -zosin
Examples Doxazosin
Prazosin
Terazosin
Mechanism of Action Inhibits alpha‑1 in arteries/bladder/prostate, causing relaxation & vasodilation
Uses/Indications Hypertension
Benign prostatic hyperplasia
Side Effects "First‑dose phenomenon"
Reflex tachycardia
Syncope
Dizziness
Fluid & sodium retention
Contraindications/Precautions Use cautiously in patients prone to falls
Nursing Interventions Monitor BP & HR (especially after first dose)
Patient Education Change positions slowly. Do not abruptly stop taking.

Alpha‑2 Agonists

AttributeDetail
Suffix None
Examples Clonidine
Mechanism of Action Stimulates alpha‑2 in CNS, causing vasodilation & reduced sympathetic outflow
Uses/Indications Hypertension
Side Effects Drowsiness
Dry mouth
Rebound HTN if stopped abruptly
Contraindications/Precautions Avoid abrupt withdrawal
Nursing Interventions Monitor BP & HR
Patient Education Take same time daily. Taper off under supervision.

Antidysrhythmics

AttributeDetail
Suffix None standardized
Examples Amiodarone
Mechanism of Action Blocks potassium channels, prolonging repolarization & slowing conduction
Uses/Indications Life‑threatening ventricular arrhythmias
Cardiac arrest
Side Effects Blue‑gray skin discoloration
Pulmonary toxicity
Liver dysfunction
Contraindications/Precautions Risk of thyroid, lung, & liver toxicity
Nursing Interventions Monitor ECG, liver enzymes, pulmonary function
Patient Education Report vision changes, cough, or skin discoloration

Statins (HMG‑CoA Reductase Inhibitors)

AttributeDetail
Suffix -statin
Examples Not specified
Mechanism of Action Inhibits HMG‑CoA reductase, decreasing cholesterol synthesis in liver
Uses/Indications Hyperlipidemia
Atherosclerosis prevention
Side Effects Muscle pain
Liver toxicity
Rhabdomyolysis
Nausea
Contraindications/Precautions Contraindicated in pregnancy. Avoid grapefruit juice.
Nursing Interventions Monitor liver enzymes, check for muscle pain
Patient Education Take in evening. Report any muscle pain or weakness.

Vasodilators

AttributeDetail
Suffix None standardized
Examples Nitroglycerin
Isosorbide
Hydralazine
Mechanism of Action Relaxes/dilates arteries, reducing afterload & improving blood flow
Uses/Indications Angina
Hypertensive crisis
Heart failure
Severe HTN
Side Effects Headache
Flushing
Orthostatic hypotension
Reflex tachycardia
Drug‑induced lupus
Contraindications/Precautions Avoid PDE5 inhibitors (e.g., sildenafil)
Nursing Interventions Monitor BP closely. Remove previous patch before applying new one
Patient Education Rise slowly. Call 911 if chest pain not relieved after 3 sublingual doses.

Loop Diuretics

AttributeDetail
Suffix -ide
Examples Not specified
Mechanism of Action Inhibits reabsorption of Na, Cl, & water in loop of Henle
Uses/Indications Edema
Hypertension
Heart failure
Renal disease
Liver disease
Side Effects Hypokalemia
Ototoxicity
Hypotension
Dehydration
Hyperglycemia
Contraindications/Precautions Avoid rapid IV push
Nursing Interventions Monitor I&O, BP, electrolytes
Patient Education Report ringing in ears. Encourage potassium‑rich foods.

Potassium-Sparing Diuretics

AttributeDetail
Suffix None
Examples Spironolactone
Mechanism of Action Inhibits aldosterone in distal tubule, retaining potassium while excreting sodium
Uses/Indications Heart failure
Hypertension
Hyperaldosteronism
Side Effects Hyperkalemia
Gynecomastia
GI upset
Contraindications/Precautions Avoid salt substitutes
Nursing Interventions Monitor potassium, BP, weight
Patient Education Report signs of hyperkalemia

Anticoagulants

AttributeDetail
Suffix -parin, -ban, -tran
Examples Heparin, Enoxaparin, Warfarin, Apixaban, Rivaroxaban, Dabigatran
Mechanism of Action (Class-Wide) Inhibit clotting cascade to prevent formation/growth of fibrin clots
Uses/Indications DVT
PE
AFib
Post‑surgery clot prevention
Side Effects Bleeding
Bruising
Hematuria
GI bleeding
Contraindications/Precautions Bleeding disorders, recent surgery, pregnancy (Warfarin)
Nursing Interventions Monitor PT/INR (Warfarin), aPTT (Heparin), signs of bleeding
Patient Education Use soft toothbrush, electric razor, avoid high‑risk activities. Maintain consistent vitamin K intake (Warfarin)

Vasopressors

AttributeDetail
Suffix None standardized
Examples Norepinephrine
Epinephrine
Phenylephrine
Vasopressin
Mechanism of Action (Class-Wide) Stimulate alpha, beta, or vasopressin receptors to cause vasoconstriction ↑BP
Uses/Indications Severe hypotension
Septic shock
Anaphylaxis
Cardiac arrest
Side Effects Tachyarrhythmias
Reflex bradycardia
Lactic acidosis (epinephrine)
Ischemia
Contraindications/Precautions Use caution in cardiac ischemia/arrhythmias
Nursing Interventions Administer via central line if long‑term. Monitor VS, ECG, urine output. Titrate to MAP. Monitor infiltration (phentolamine if extravasation)
Patient Education Not typically used outside critical care; explain monitoring, central access, short‑term use

Cardiotonic Agents

AttributeDetail
Suffix None standardized
Examples Digoxin
Dobutamine
Dopamine
Milrinone
Mechanism of Action (Class-Wide) Increase cardiac contractility (positive inotrope) → improved CO
Uses/Indications Heart failure
Cardiogenic shock
Atrial fibrillation/flutter (Digoxin)
Side Effects Ventricular arrhythmias
Thrombocytopenia (Milrinone)
Nausea
Headache
Palpitations
Contraindications/Precautions Hold Digoxin if HR < 60 bpm. Risk of toxicity in renal impairment. Caution in arrhythmias
Nursing Interventions Monitor apical pulse (Digoxin), electrolytes, renal, ECG. Strict I&O. Continuous monitoring if IV
Patient Education Teach signs of Digoxin toxicity (vision changes, nausea, vomiting, dizziness). Report palpitations or irregular heartbeat

Thiazide Diuretics

AttributeDetail
Suffix -thiazide
Examples Hydrochlorothiazide (HCTZ)
Chlorothiazide
Mechanism of Action Block reabsorption of sodium & water in distal tubule, promoting diuresis
Uses/Indications Hypertension
Heart failure (adjunct)
Liver disease
Side Effects Hypokalemia
Hyponatremia
Hyperuricemia
Hypercalcemia
Dehydration
Contraindications/Precautions Avoid in gout or renal failure
Nursing Interventions Monitor BP, daily weights, I&O, electrolytes. Encourage potassium‑rich foods
Patient Education Take in morning. Report dizziness or muscle cramps. Increase fluids unless contraindicated

Osmotic Diuretics

AttributeDetail
Suffix None
Examples Mannitol
Mechanism of Action Increases serum osmolality, drawing water out of cells → excretion
Uses/Indications Cerebral edema (↑ICP)
Increased intraocular pressure (glaucoma)
Side Effects Pulmonary edema
Dehydration
Fluid volume overload
Hypotension
Contraindications/Precautions Avoid in active cranial bleed or anuria
Nursing Interventions Monitor I&O, electrolytes, VS. Administer via filter if crystallized
Patient Education Explain rationale. Report chest pain/swelling. Used only in monitored settings

Direct Renin Inhibitors

AttributeDetail
Suffix None standardized
Examples Aliskiren (Tekturna)
Mechanism of Action Binds to renin, inhibiting conversion of angiotensinogen → angiotensin I, lowering BP
Uses/Indications Hypertension
Side Effects Diarrhea
Hyperkalemia
Hypotension
Rare cough or angioedema
Contraindications/Precautions Contraindicated in pregnancy. Use caution in renal impairment & with ACE/ARBs
Nursing Interventions Monitor BP, renal function, electrolytes
Patient Education Take as prescribed. Report persistent side effects. Notify provider if pregnant.