In: Nursing
2. Mr. Tinsley returns to the clinic 1 month later
for reevaluation. His blood pressure is 140/72 and he is
complaining of an irritating cough. The health care provider
discontinued the ACE inhibitor and started on diltiazem
(Cardizem)).
a. Explain why only the ACE inhibitor was discontinued.
b. How does diltiazem treat hypertension?
c. Mr. Tinsley says that his BP is really not that high so why does
he really need this medication. How should you respond?
(a). Patient is reported with irritating cough. This is the main side effect of ACE inhibitors. That is the to discontinue ACE inhibitors. Still patient has hypertension so he need to be on another antihypertensive drug.
(b). Diltiazem is an antihypertensive drug coming under the class of calcium channel blockers. Calcium channel blockers reduces blood pressure by preventing the entry of calcium to heart and arteries. Calcium make heart and arteries to contract more strongly. So use of diltiazem helps to control blood pressure.
(c) Diltiazem works by relaxing the blood vessels so that heart can pump blood without much strain. Thereby it increases the blood and oxygen supply to the heart. Diltiazem can control hypertension but it cannot cure it fully. The effect of diltiazem will take long time to get full benefits. So patient has to be on diltiazem to get blood pressure in control.