Colleen S.

De la Rosa
BSN III
Drug Study

Brand Name & Indication Mechanism of Action Dosage Adverse Reaction Nursing Consideration
Generic Name
Norvasc 1st-line Amlodipine is a dihydropyridine calcium HTN, chronic Flushing, fatigue, Assessment
(amlodipine treatment of antagonist (calcium ion antagonist or slow- stable edema, dizziness, History: Allergy to amlodipine, impaired hepatic or
besylate) HTN & channel blocker) that inhibits the angina Initial dose: headache, renal function, sick sinus syndrome, heart block,
myocardial transmembrane influx of calcium ions into 5 mg once daily & abdominal pain, lactation, CHF
ischemia. vascular smooth muscle and cardiac muscle. may be increased to nausea, Physical: Skin lesions, color, edema; P, BP, baseline
Reduce the risk Experimental data suggest that amlodipine binds a max of 10 palpitations & ECG, peripheral perfusion, auscultation; R,
of coronary to both dihydropyridine and nondihydropyridine mg.Patients w/ somnolence. adventitious sounds; liver evaluation, GI normal
revascularizatio binding sites. The contractile processes of CAD Recommende output; liver and renal function tests, urinalysis
n & the need for cardiac muscle and vascular smooth muscle are d dosage range: 5- Interventions
hospitalization dependent upon the movement of extracellular 10 mg once WARNING: Monitor patient carefully (BP, cardiac
due to angina in calcium ions into these cells through specific daily. Ped patients rhythm, and output) while adjusting drug to therapeutic
patients w/ ion channels. Amlodipine inhibits calcium ion 6-17 yr Initial dose: dose; use special caution if patient has CHF.
CHD; reduce the influx across cell membranes selectively, with a 2.5-5 mg once Monitor BP very carefully if patient is also on nitrates.
risk of fatal greater effect on vascular smooth muscle cells daily. Dose should Monitor cardiac rhythm regularly during stabilization
CHD, nonfatal than on cardiac muscle cells. Negative inotropic not exceed 5 mg of dosage and periodically during long-term therapy.
MI & to reduce effects can be detected in vitro but such effects daily. Administer drug without regard to meals.
the risk of have not been seen in intact animals at Teaching points
stroke. therapeutic doses. Serum calcium concentration Take with meals if upset stomach occurs.
is not affected by amlodipine. Within the You may experience these side effects: Nausea,
physiologic pH range, amlodipine is an ionized vomiting (eat frequent small meals); headache (adjust
compound (pKa=8.6), and its kinetic interaction lighting, noise, and temperature; medication may be
with the calcium channel receptor is ordered).
characterized by a gradual rate of association Report irregular heartbeat, shortness of breath, swelling
and dissociation with the receptor binding site, of the hands or feet, pronounced
resulting in a gradual onset of effect. dizziness, constipation.
Brand Name & Indication Mechanism of Action Dosage Adverse Reaction Nursing Consideration
Generic Name
Telmistran Treatment of Telmisartan is a member of a family Treatment of UTI, upper resp tract special precaution inpatients
(Micardis) essential HTN. of drugs called angiotensin receptor essential infection, sepsis, anemia, with impaired hepatic and
Prevention of CV blockers (ARBs), which HTN Recommended eosinophilia, renal impairment
morbidity & includes losartan (Cozaar), valsartan ( dose: 40 mg once thrombocytopenia,
mortality in Diovan), irbesartan (Avapro), and daily. Prevention of anaphylactic reaction, -special precaution with volume
patients 55 yr at candesartan (Atacand). Angiotensin, CV morbidity & hypersensitivity, and ./or Na-depleted patients
high risk of CV formed in the blood by the action mortality Recomme hyperkalemia,
disease. of angiotensin converting nded dose: 80 mg hypoglycemia, insomnia, -may impair ability to drive or
enzyme (ACE), is a powerful once daily. depression, anxiety, syncope, operate machineries
chemical that attaches to angiotensin visual disturbance, vertigo,
receptors found in many tissues but bradycardia, tachycardia,
primarily on muscle cells of blood hypotension, orthostatic
vessels. Angiotensin's attachment to hypotension, dyspnea,
the receptors causes muscle cells to abdominal pain, diarrhea,
shorten and narrow the blood vessels dyspepsia, flatulence,
(vasoconstrict), which leads to an vomiting, dry mouth,
increase in blood stomach discomfort, pruritus,
pressure (hypertension). Telmisartan hyperhidrosis, rash,
blocks the angiotensin receptor. By angioedema, eczema,
blocking the action of angiotensin, erythema, urticarial, drug
telmisartan widens blood vessels eruption, toxic skin eruption,
(vasodilate) and reduces blood back pain, muscle spasm,
pressure myalgia, arthralgia, pain in
extremity, tendon pain, renal
impairment including acute
renal failure, chest pain,
asthenia, influenza-like
illness.