Antihypertensive Medications
Hypertension is defined as an elevated blood pressure above the acceptable range. Currently, a reading of 120 – 139 mmhg (millimiters of mercury) for
systolic and 80-89 mmhg for diastolic means that the person is in the
prehypertension stage, a reading of 140 – 159 mmhg for systolic and 90-99 mmhg
for diastolic means stage 1 of hypertension, a reading of 160 mmhg for systolic
and 100 mmhg for diastolic means stage 2 of hypertension and a reading of 180
mmhg for systolic and 110 mmhg for diastolic means that the individual is in
hypertensive crisis.
The treatment of hypertension is done in different ways. One of the method is using an antihypertensive medication. Prescribing a drug called diuretic is one of the option among others. Diuretics are drugs that promote the process of diuresis [an
increase in water retention] resulting in an increase in urination. The
classifications of diuretics are thiazides, potassium sparing, carbonic
anhydrase inhibitors, xanthines and loop diuretics.
Commonly prescribed thiazide diuretics are
bendroflumethiazide and hydrochlorothiazide. These drugs inhibit the
reabsorption of sodium at the distal convoluted tubules of the kidneys. The
common adverse effects are muscle cramps and weakness, thirst, hypotension, confusion,
fatigue, hypokalemia (low levels of potassium) and gastrointestinal
disturbances such as nausea and vomiting. The potassium sparing diuretics that
are commonly prescribed are spironolactone, triamterene and amiloride. These
drugs function to inhibit the exchange between sodium and potassium in the
collecting ducts of the kidneys. The adverse effects are hyperkalemia (elevated
levels of potassium) resulting in arrhythmia and muscle weakness, and metabolic
acidosis that results in seizures, coma, lethargy and breathing difficulties.
The carbonic anhydrase inhibitors diuretics that are
commonly prescribed are azetazolamide and dorzolamide. These drugs function to
inhibit the secretion of hydrogen ions in the proximal tubules of the kidneys.
The common adverse effects are hypokalemia and central nervous system
disturbances such as seizures and coma. The commonly prescribed xanthine
diuretics are theophylline, theobromine and caffeine. These drugs function to
inhibit reabsorption of sodium and increase the glomerular filtration rate of
the kidneys. Theophylline is not generally recommended because of the toxic
effects to the cardiovascular system.
Over all, the general adverse effects of diuretics are
imbalances in the potassium levels in the blood, hypercalcemia (elevated levels
of calcium), hyponatremia (lower levels of sodium), hyperuricemia (excessive
uric acid in the blood) and orthostatic hypotension (postural hypotension).
Diuretics are contraindicated for people with gout because it will elevate the
uric acid in the blood.
A health teaching regarding the adverse effects of diuretics
should be done by the healthcare provider. Monitoring other bodily reactions
such as weight changes and neurological deficits is needed due to concern over potential
negative effects of the drug to the body. Constant updates to the healthcare
providers regarding bodily changes are important so that necessary adjustment
in the dosage can be promptly done.
You can read more about hypertension in my books : Blood Pressure Management : Hypertension and Hypotension A Guide for Patients, Nurses and other HealthcareProfessionals ( Available at Amazon.com; link : http://www.amazon.com/Blood-Pressure-Management-Professionals-ebook/dp/B00AK85EBC ). Managing Blood Pressure Effectively A Guide for Well Informed Patients, Nurses and Other Healthcare Professionals ( Available at Smashwords.com; link : https://www.smashwords.com/books/view/276367 ). Both books are downloadable as ebooks.
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See you next time.
Solomon Barroa R.N.
Home Health Nurse and Medical Author