Antihypertensive drugs affect different areas of blood pressure control so in most cases, these agents are combined for synergistic effect. Different people have different responses towards hypertensive agents because hypertension is multifactorial. For instance, the presence of comorbidities (e.g. diabetes, myocardial infarction, etc.) may make some antihypertensive not suitable for treatment. There are vital nursing interventions done in patients who are taking ACE inhibitors. Educate patient on importance of health lifestyle choices which include regular exercise, weight loss, smoking cessation, and low-sodium diet to maximize the effect of antihypertensive therapy. Administer drug on empty stomach one hour before or two hours after meal to ensure optimum drug absorption.
ant nephrosclerosis is uncommon and affects 1-5% of individuals with high blood pressure, that have diastolic blood pressure passing 130 mm Hg.46The relative risk of developing ESRD is increased by up to 20 times in hypertensive patients.47
In addition, the glomerulus has a unique structure, with both an afferent and an efferent arteriole, which permits modulation of glomerular perfusion and pressure without corresponding systemic blood pressure change.48
When the force of blood flow is high, blood vessels stretch so blood flows more easily. Eventually, this stretching scars and weakens blood vessels throughout the body, including those in the kidneys. If the kidneys’ blood vessels are damaged, they may stop removing wastes and extra fluid from the body. Extra fluid in the blood vessels may then raise blood pressure even more, creating a dangerous cycle. And opposite action in hypotension.49
Drug-induced nephrotoxicity, is a major cause of acute renal failure chronic kidney disease. It occurs due to the easy availability of over-the-counter medication viz. non-steroidal anti-inflammatory drugs (NSAIDs). Antibiotics, NSAIDs, angiotensin converting enzyme inhibitors (ACEI) and contrast agents are the major drugs contributory to kidney damage.Among antibiotics especially aminoglycoside antibiotics have been the most common offending agent’s leads to chronic kidney disease. Chronic renal injury can be induced by some medications, leading to chronic tubule-interstitial inflammation, papillary necrosis or prolonged proteinuria. Drug-induced acute renal failure (ARF) accounted for 20% of all ARF.50,51Mainly anti-tubercular, anti-epileptic and chemotherapeutic agents are most responsible for the kidney damage.
Example: NSAIDs (Diclofenac Ibuprofen, Ketoprofen), Aminoglycoside antibiotics (gentamicin, amikacinesterptomycine) Amphotericin B, cyclosporine, rifampicin indinavir and more other drugs.52
What is Nephrotic syndrome?
