NIFEDPINE.pdf - ACTIVE LEARNING TEMPLATE Medication Jen Forbes STUDENT NAME NEFEDPINE MEDICATION REVIEW MODULE CHAPTER antihypertensives\/calcium channel

NIFEDPINE.pdf - ACTIVE LEARNING TEMPLATE Medication Jen...

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Unformatted text preview: ACTIVE LEARNING TEMPLATE: Medication Jen Forbes STUDENT NAME______________________________________ NEFEDPINE MEDICATION___________________________________________________________________________ REVIEW MODULE CHAPTER____________ antihypertensives/calcium channel blockers CATEGORY CLASS__antianginals, _____________________________________________________________________ PURPOSE OF MEDICATION Expected Pharmacological Action Inhibits calcium transport into myocardial and vascular smooth muscle cells, resultIng in inhibition of excitation-contraction coupling and subsequent contraction. Therapeutic Use Systemic vasodilation, resulting in decreased BP. Coronary vasodilation, resulting in decreased frequency and severity of attacks of angina Complications May cause Stevens-Johnson syndrome. May cause HF. headache, abnormal dreams, anxiety, confusion, dizziness, drowsiness, jitteriness, nervousness, psychiatric disturbances, weakness, dyspnea, shortness of breath. ARRHYTHMIAS, HF, peripheral edema, bradycardia, chest pain, hypotension, pal-pitations, syncope, tachycardia Medication Administration PO (Adults):10 – 30 mg 3 times daily (not to exceed 180 mg/day),or10 – 20 mg twice daily as immediate-release form,or 30 – 90 mg once daily as sustained-release(CC, XL) form (not to exceed 90 – 120 mg/day) Contraindications/Precautions Contraindicated in:Hypersensitivity; Some products contain tartrazine and should be avoided in patients with known intolerance. Use Cautiously in:Cardiovascular or cerebrovascular disease; Severe renal and hepatic disease (dose modification may be necessary);OB, Lactation:Has been used safely during pregnancy. Interactions Rifampin,rifabutin,phenobarbital,phenytoin,orcarbamaze-pinemay significantly decreases levels and effects; concurrent use is contraindicated.Keto-conazole,fluconazole,itraconazole,clarithromycin,erythromycin,nefazodone,saquinavir,indinavir,nelfinavir ,or ritonavir may increase levels and effects. Additive hypotension may occur when used concurrently with fentanyl, other antihypertensive ,nitrates, acute ingestion of alcohol,or quinidine. Antihypertensive effects may be decrease by concurrent use of NSAIDs. May increase serum levels and risk of toxicity from digoxin. Concurrent use with beta blockers,digoxin,or disopyramidemay result in bradycardia, con-duction defects, or HF.Cimetidine and propranolol may decrease metabolism and increase risk of toxicity. May decrease metabolism of and increase risk of toxicity from cyclosporine,tacrolimus,prazosin,quinidine,or carbamazepine. St. John’s wort may significantly decrease levels and effects. Grapefruit increase serum levels and effect Evaluation of Medication Effectiveness Decrease in BP, Decrease in frequency and severity of anginal attacks, Decrease in need for nitrate therapy, Increase in activity tolerance and sense of wellbeing in patients with HF. ACTIVE LEARNING TEMPLATES Nursing Interventions Monitor BP and pulse before therapy, during dose titration, and periodically during therapy. Monitor ECG periodically during prolonged therapy. Monitor intake and output ratios and daily weight. Assess for signs of HF(peripheral edema, rales/crackles, dyspnea, weight gain, jugular venous distention) Client Education Instruct patient to contact health care professional if heart rate is 50 bpm. Advise patient to avoid grapefruit or grapefruit juice during therapy. Caution patient to change positions slowly to minimize orthostatic hypotension. May cause drowsiness or dizziness. Advise patient to avoid driving or other activities requiring alertness until response to the medication is known. Advise patient to notify health care professional if rash, irregular heart-beat, dyspnea, swelling of hands and feet, pronounced dizziness, nausea, constipation, or hypotension occurs or if headache is severe or persistent. Therapeutic Procedure  A7 ...
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