Antihypertensive Medications for NCLEX: ACE Inhibitors, ARBs, Beta-Blockers & More
Comprehensive NCLEX review of antihypertensive drug classes. Learn ACE inhibitors, ARBs, beta-blockers, CCBs, and diuretics for nursing exams.
Antihypertensive Medications: Essential NCLEX Pharmacology
Hypertension affects nearly half of American adults, making antihypertensive medications one of the most heavily tested pharmacology topics on the NCLEX. Understanding drug classes, mechanisms, and nursing considerations is critical.
ACE Inhibitors
ACE inhibitors (ending in -pril: lisinopril, enalapril, captopril) block the conversion of angiotensin I to angiotensin II, reducing vasoconstriction and aldosterone secretion. They are first-line for hypertension, heart failure, and diabetic nephropathy. The most common side effect is a persistent dry cough due to bradykinin accumulation. Serious adverse effects include angioedema and hyperkalemia. ACE inhibitors are contraindicated in pregnancy (teratogenic). Monitor potassium levels and renal function. Do not combine with potassium-sparing diuretics.
ARBs (Angiotensin II Receptor Blockers)
ARBs (ending in -sartan: losartan, valsartan, irbesartan) block angiotensin II receptors directly. They have similar benefits to ACE inhibitors but without the cough. They are an alternative for patients who cannot tolerate ACE inhibitors. Same pregnancy and hyperkalemia warnings apply.
Beta-Blockers
Beta-blockers (ending in -olol: metoprolol, atenolol, propranolol, carvedilol) reduce heart rate and contractility, decreasing cardiac output and blood pressure. They are used for hypertension, heart failure, angina, and arrhythmias. Monitor for bradycardia (hold if heart rate is below 60 bpm) and hypotension. Teach patients not to stop abruptly as rebound hypertension can occur. Beta-blockers may mask hypoglycemia symptoms in diabetic patients. Contraindicated in asthma as they cause bronchospasm.
Calcium Channel Blockers
Dihydropyridines (amlodipine, nifedipine) primarily cause vasodilation. Non-dihydropyridines (diltiazem, verapamil) also reduce heart rate. Avoid grapefruit juice as it increases drug levels. Monitor for peripheral edema, especially with dihydropyridines.
Diuretics
Thiazides (hydrochlorothiazide) are first-line for hypertension. Loop diuretics (furosemide) are used for fluid overload. Both cause hypokalemia. Monitor electrolytes, especially potassium. Review more at our pharmacology flashcards and practice pharmacology mini-exams.