Our Pharmacology video tutorial series is taught by Cathy Parkes BSN, RN, CWCN, PHN and intended to help RN and PN nursing students study for their nursing school exams, including the ATI, HESI and NCLEX.
0:00 What to Expect 0:25 Calcium Channel Blockers 0:52 Indications 1:02 Mode of Action 1:17 Side Effects 1:44 Patient Teaching 1:59 Centrally-Acting Alpha-2 Agonist 2:15 Indications 2:32 Mode of Action 2:43 Side Effects 2:57 Beta-1 Blockers 3:48 Mode of Action 4:01 Side Effects 4:11 Black Box Warning 4:23 Patient Teaching/ Nursing Care 4:47 Non-selective Beta Blockers 6:04 Mode of Action 6:14 Side Effects 6:54 What’s Next?
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Content
0.78 -> Alright.
1.78 -> In this video, we are going to talk about
more medications that are used to treat hypertension.
7.099 -> Specifically, we'll be talking about calcium
channel blockers, alpha-2 agonists, beta-1
14.16 -> blockers, and non-selective beta blockers.
17.72 -> If you are following along with cards, I'm
on card number 15 in the Edition 2.0 deck.
24.73 -> Alright.
25.73 -> Now let's talk about calcium channel blockers.
28.27 -> So medications that fall within this class
include verapamil, nifedipine, and diltiazem.
34.859 -> And the way that I remember that these medications
are calcium channel blockers is I think, "Calcium
41.67 -> channel blockers are very nice drugs."
44.699 -> So V for verapamil, N for nifedipine, and
D for diltiazem.
52.48 -> So these medications are used to treat hypertension
as well as angina.
58.399 -> And then nifedipine is also used to treat
pre-term labor.
62.89 -> So the mode of action of calcium channel blockers
are to block calcium channels in the heart
69.75 -> and in the blood vessels.
71.95 -> This results in vasodilation and a decrease
in the heart rate.
77.88 -> Key side effects include peripheral edema.
81.53 -> That's a really important one to know.
83.659 -> As well as hypotension, which you probably
could have guessed, right?
86.97 -> Anytime we have a medication that treats hypertension
and it does its job too well, hypotension
93.799 -> is likely going to be a key side effect.
96.78 -> Other side effects include bradycardia because
we're affecting the heart rate, as well as
101.95 -> headache and constipation.
104.689 -> So important teaching that you need to do
for your patient, you need to advise them
109.259 -> not to consume grapefruit juice.
112.28 -> And you're definitely going to want to monitor
their blood pressure, as well as their heart
116.409 -> rate, carefully during therapy.
118.799 -> Alright.
119.799 -> Now we're going to talk about a centrally-acting
alpha-2 agonist.
125 -> So the medication to know in this class is
clonidine.
128.819 -> It's going to be really important that you
not mix up clonidine with clozapine.
135.34 -> So clozapine with a Z is for schizophrenia
which also has a Z. Clonidine does not have
144.629 -> a Z.
145.629 -> It's not for schizophrenia.
147.599 -> It's for hypertension, okay?
150.239 -> So we use this for hypertension.
152.43 -> It works by decreasing the sympathetic outflow
to the heart and blood vessels which results
159.26 -> in decreased heart rate and decreased blood
pressure.
163.65 -> The key side effects to remember are the 3
Ds of clonidine.
170.4 -> And this includes dizziness, drowsiness, and
dry mouth.
175.29 -> So again, 3 Ds of clonidine.
177.049 -> And one important teaching to give your patient
is that they can suck on hard candy or chew
183.53 -> gum for a dry mouth.
185.44 -> Alright.
186.44 -> Now let's talk about beta-1 blockers which
include metoprolol, as well as atenolol.
193.129 -> So next we'll be talking about non-selective
beta blockers.
196.939 -> The way that you can remember which medications
are beta-1 blockers is that you only have
203.87 -> one mother.
204.87 -> You might actually have more than one mother.
206.72 -> But let's say you have one mother or one ma.
210.409 -> And that will help you remember that beta-1
blockers are metoprolol and atenolol, which
217.47 -> start with M and A. So these medications are
used for hypertension, angina, a heart failure
225.17 -> as well as a myocardial infarction.
228.44 -> The mode of action is that they block beta-1
receptors which are on the heart, right.
233.51 -> You only have one heart so those are beta-1
receptors.
237.38 -> And this helps to decrease blood pressure
as well as heart rate.
242.019 -> So side effects of this medication include
bradycardia, hypotension, fatigue, and erectile
250.12 -> dysfunction.
251.519 -> This medication also carries a black box warning
because if you discontinue taking this medication
258.16 -> abruptly, it can cause angina as well as an
MI.
263.419 -> So it's going to be important to teach your
patient to change positions slowly because
267.86 -> of that hypotension.
269.72 -> You're also going to want to monitor their
blood pressure and pulse during therapy.
274.77 -> And also keep in mind that beta-1 blockers
can mask signs of hypoglycemia.
281.28 -> So if you have a patient who has diabetes,
this is going to be an important point to
286.46 -> know.
287.46 -> Now let's talk about non-selective beta blockers.
291.87 -> So these are beta blockers that not only affect
beta-1 receptors in the heart, they also affect
298.6 -> beta-2 receptors in the lungs.
301.75 -> So medications that fall within this class
include propranolol, labetalol, and carvedilol.
308.43 -> So again, they all end in that -olol, but
it's important to know how you can determine
314.59 -> that these are non-selective as opposed to
the beta-1 blockers that we talked about last.
319.97 -> So if you recall with the beta-1 blockers,
you have 1 ma, in all likelihood.
325.19 -> So beta-1 blockers include metoprolol as well
as atenolol.
330.65 -> For non-selective beta blockers, the way I
remember this is I think, "Please listen carefully."
338.169 -> And that helps me remember propranolol, labetalol,
and carvedilol.
343.8 -> "Please listen carefully."
346.02 -> These medications not only affect the beta-1
receptors, they also affect the lungs too.
352.68 -> And that's going to be a really important
point with these non-selective beta blockers.
357.55 -> So they are used to treat hypertension, angina,
as well as arrhythmias or an MI.
364.62 -> They work by blocking the beta-1 receptors
in the heart as well as the beta-2 receptors
370.43 -> in the lungs.
371.47 -> They decrease blood pressure and heart rate.
374.789 -> But a key side effect, and one that's really
important for you to know, is bronchospasm.
380.72 -> Because they are affecting those beta-2 receptors
in the lungs, you would never want to give
386.47 -> this medication to someone who had asthma
or issues that would be exacerbated by bronchoconstriction.
394.84 -> Other side effects include fatigue, hypotension,
bradycardia, as well as erectile dysfunction.
403.169 -> And again, no using this medication for patients
with asthma because of that bronchospasming
410.889 -> because we are affecting the lungs too.
413.259 -> Alright.
414.259 -> In my next video, we are going to talk about
vasodilators that are used for angina as well
