Drugs_That_Increase_Blood_Pressure .pptx

Drugs_That_Increase_Blood_Pressure .pptx

• 1.
  Name : IshikaKakani DRUGS THAT INCREASE BLOOD PRESSURE
• 2.
  • DEFINITION: BLOODPRESSURE (BP) IS THE FORCE EXERTED BY CIRCULATING BLOOD ON ARTERIAL WALLS. • NORMAL BP: <120/80 MMHG • DRUG-INDUCED HYPERTENSION: RISE IN BP CAUSED BY MEDICATION USE. • IMPORTANCE: RECOGNIZING THESE DRUGS HELPS PREVENT COMPLICATIONS.
• 3.
  MECHANISMS OF DRUG-INDUCED HYPERTENSION •• INCREASED SYMPATHETIC ACTIVITY VASOCONSTRICTION & → INCREASED HR • • FLUID RETENTION INCREASED BLOOD VOLUME → • • ALTERED RENIN-ANGIOTENSIN SYSTEM (RAS) → VASOCONSTRICTION • • DECREASED VASODILATOR EFFECTS (INHIBITION OF NITRIC OXIDE)
• 4.
  SYMPATHOMIMETIC AGENTS • PSEUDOEPHEDRINE:60 MG PO Q4–6H (MAX 240 MG/DAY) • PHENYLEPHRINE: 10 MG PO Q4H (MAX 60 MG/DAY) • AMPHETAMINE (ADDERALL): 5–30 MG PO 1–2×/DAY • COCAINE: RECREATIONAL/TOPICAL USE VASOCONSTRICTION → • MECHANISM: STIMULATE ADRENERGIC RECEPTORS → ↑ NOREPINEPHRINE BP → ↑
• 5.
  CORTICOSTEROIDS • PREDNISONE: 5–60MG/DAY PO • DEXAMETHASONE: 0.5–10 MG/DAY PO OR IV • MECHANISM: SODIUM & WATER RETENTION, SENSITIVITY TO ↑ CATECHOLAMINES • EFFECT: VOLUME EXPANSION INCREASED BP → • MONITORING: BP & ELECTROLYTE CHECKS
• 6.
  NSAIDS (NONSTEROIDAL ANTI- INFLAMMATORYDRUGS) • IBUPROFEN: 200–400 MG Q4–6H (MAX 1200 MG/DAY OTC) • NAPROXEN: 250–500 MG BID • INDOMETHACIN: 25–50 MG BID–TID • MECHANISM: PROSTAGLANDINS RENAL PERFUSION ↓ → ↓ → SODIUM RETENTION • RESULT: BP (ESP. ELDERLY/RENAL IMPAIRMENT) ↑ • ALTERNATIVE: ACETAMINOPHEN (MINIMAL BP EFFECT)
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  ORAL CONTRACEPTIVES &HORMONAL DRUGS • COMBINED OCPS (ETHINYLESTRADIOL + LEVONORGESTREL): 1 TABLET DAILY • ANABOLIC STEROIDS (NANDROLONE): 50–100 MG IM Q1–4 WEEKS • MECHANISM: ANGIOTENSINOGEN, FLUID RETENTION, ↑ ↑ VASCULAR TONE • NOTE: BP NORMALIZES AFTER DISCONTINUATION
• 8.
  OTHER DRUGS &PREVENTION • ERYTHROPOIETIN (EPO): 50–150 U/KG SC/IV 3×/WEEK • CYCLOSPORINE: 3–5 MG/KG/DAY PO • TACROLIMUS: 0.1–0.2 MG/KG/DAY PO • MAO INHIBITORS (PHENELZINE 15 MG TID) + TYRAMINE CRISIS → • CAFFEINE: 100–200 MG TRANSIENT BP INCREASE • NICOTINE: 1 CIGARETTE TRANSIENT BP RISE → • PREVENTION: • • REVIEW MEDS • MONITOR BP • SUBSTITUTE OFFENDING DRUGS • • LIFESTYLE: LOW-SODIUM DIET, EXERCISE, STRESS MANAGEMENT