Medical Surgery - Drug Study - DIMACALI by Julmar Dimacali

dimacalijulmar — 2021-09-16 12:40:39 UTC

dimacalijulmar — 2021-09-16 12:41:16 UTC

Generic Name

Captopril

dimacalijulmar — 2021-09-16 12:41:36 UTC

Brand Name

Capoten

dimacalijulmar — 2021-09-16 12:41:59 UTC

Stock Dosage
Tablets:12.5 mg, 25 mg, 50 mg, 100 mg

dimacalijulmar — 2021-09-16 12:43:42 UTC

Classification

CARDIOVASCULAR AGENT; ANGIOTENSIN-CONVERTING ENZYME (ACE) INHIBITOR; ANTIHYPERTENSIVE AGENT

Pregnancy Category: D

dimacalijulmar — 2021-09-16 12:45:10 UTC

Mechanism of Action

Lowers blood pressure by specific inhibition of the angiotensin-converting enzyme (ACE). This interrupts conversion sequences initiated by renin that lead to formation of angiotensin II, a potent endogenous vasoconstrictor. ACE inhibition alters hemodynamics without compensatory reflex tachycardia or changes in cardiac output (except in patients with CHF). Peripheral vascular resistance is lowered by vasodilation. Inhibition of ACE also leads to decreased circulating aldosterone. Reduced circulating aldosterone is associated with a potassium-sparing effect. In heart failure, captopril administration is followed by a fall in CVP and pulmonary wedge pressure; hypotensive action appears to be unrelated to plasma renin levels.

dimacalijulmar — 2021-09-16 12:45:45 UTC

Indication/s

Indicated to patients:

Treatment of hypertension, HF, diabetic nephropathy, post-MI for prevention of ventricular failure.

dimacalijulmar — 2021-09-16 12:46:02 UTC

Contraindications

Contraindicated to patients with:

Angioedema, hypersensitivity to captopril or ACE inhibitors; hypotension; pregnancy (category D), lactation.

dimacalijulmar — 2021-09-16 12:46:21 UTC

Side Effects and Adverse Effects

Body as a Whole: Hypersensitivity reactions, serum sickness-like reaction, arthralgia, skin eruptions.

CV: Slight increase in heart rate, first dose hypotension, dizziness, fainting.

GI: Altered taste sensation (loss of taste perception, persistent salt or metallic taste); weight loss, intestinal angioedema.

Hematologic: Hyperkalemia, neutropenia, agranulocytosis (rare).

Skin: Maculopapular rash, urticaria, pruritus, angioedema, photosensitivity.

Urogenital: Azotemia, impaired renal function, nephrotic syndrome, membranous

dimacalijulmar — 2021-09-16 12:46:40 UTC

Nursing Responsibilities

Assessment & Drug Effects

Monitor BP closely following the first dose. A sudden exaggerated hypotensive response may occur within 1–3 h of first dose, especially in those with high BP or on a diuretic and restricted salt intake.
Advise bed rest and BP monitoring for the first 3 h after the initial dose.
Monitor therapeutic effectiveness. At least 2 wk of therapy may be required before full therapeutic effects are achieved.
Lab tests: Establish baseline urinary protein levels before initiation of therapy and check at monthly intervals for the first 8 mo of treatment and then periodically thereafter. Perform WBC and differential counts before therapy is begun and at approximately 2-wk intervals for the first 3 mo of therapy and then periodically thereafter.

Patient & Family Education

Report to physician without delay the onset of unexplained fever, unusual fatigue, sore mouth or throat, easy bruising or bleeding (pathognomonic of agranulocytosis).
Mild skin eruptions are most likely to appear during the first 4 wk of therapy and may be accompanied by fever and eosinophilia.
Consult physician promptly if vomiting or diarrhea occur.
Report darkening or crumbling of nailbeds (reversible with dosage reduction).
Taste impairment occurs in 5–10% of patients and generally reverses in 2–3 mo even with continued therapy.
Use OTC medications only with approval of the physician. Inform surgeon or dentist that captopril is being taken. Alert diabetic patient that captopril may produce hypoglycemia. Monitor blood glucose and HbA_1c closely during first few weeks of therapy.
Do not breast feed while taking this drug

DIGOXIN 💊

dimacalijulmar — 2021-09-16 12:47:38 UTC

dimacalijulmar — 2021-09-16 12:49:11 UTC

dimacalijulmar — 2021-09-16 12:49:30 UTC

dimacalijulmar — 2021-09-16 12:49:58 UTC

Generic Name

Digoxin

dimacalijulmar — 2021-09-16 12:50:15 UTC

Brand Name

Lanoxin

dimacalijulmar — 2021-09-16 12:50:45 UTC

Stock Dosage

Capsules: 0.05 mg, 0.1 mg, 0.2 mg

Tablets: 0.125 mg, 0.25 mg, 0.5 mg

Elixir: 0.05 mg/mL 0.25 mg/mL

Injection: 0.1 mg/mL

dimacalijulmar — 2021-09-16 12:51:02 UTC

Classification

CARDIOVASCULAR AGENT; CARDIAC GLYCOSIDE; ANTIARRHYTHMIC

Pregnancy Category: A

dimacalijulmar — 2021-09-16 12:51:26 UTC

Mechanism of Action

Widely used cardiac glycoside of Digitalis lanata. Acts by increasing the force and velocity of myocardial systolic contraction. It also decreases conduction velocity through the atrioventricular node. Action is more prompt and less prolonged than that of digitalis and digitoxin.

dimacalijulmar — 2021-09-16 12:52:41 UTC

Indication/s

Indicated to patients:

Treatment of mild to moderate HF. Control ventricular response rate in pts with chronic atrial fibrillation.
OFF-LABEL: Fetal tachycardia with or without hydrops; decrease ventricular rate in supraventricular tachyarrhythmias.

dimacalijulmar — 2021-09-16 12:53:04 UTC

Contraindications

Contraindicated to patients with:

Digitalis hypersensitivity, ventricular fibrillation, ventricular tachycardia unless due to CHF. Full digitalizing dose not given if patient has received digoxin during previous week or if slowly excreted cardiotonic glycoside has been given during previous 2 wk.

dimacalijulmar — 2021-09-16 12:53:31 UTC

Side Effects and Adverse Effects

CNS: Fatigue, muscle weakness, headache, facial neuralgia, mental depression, paresthesias, hallucinations, confusion, drowsiness, agitation, dizziness.

CV: Arrhythmias, hypotension, AV block.

Special Senses: Visual disturbances.

GI: Anorexia, nausea, vomiting, diarrhea.

dimacalijulmar — 2021-09-16 12:54:01 UTC

Nursing Responsibilities

Assessment & Drug Effects

Take apical pulse for 1 full min, noting rate, rhythm, and quality before administering drug.
Withold medication and notify physician if apical pulse falls below ordered parameters (e.g., <50 or 60/min in adults and <60 or 70/min in children).
Be familiar with patient's baseline data (e.g., quality of peripheral pulses, blood pressure, clinical symptoms, serum electrolytes, creatinine clearance) as a foundation for making assessments.
Lab tests: Baseline and periodic serum digoxin, potassium, magnesium, and calcium. Draw blood samples for determining plasma digoxin levels at least 6 h after daily dose and preferably just before next scheduled daily dose.
Monitor for S&S of drug toxicity: In children, cardiac arrhythmias are usually reliable signs of early toxicity. Early indicators in adults (anorexia, nausea, vomiting, diarrhea, visual disturbances) are rarely initial signs in children.
Monitor I&O ratio during digitalization, particularly in patients with impaired renal function. Also monitor for edema daily and auscultate chest for rales.
Monitor serum digoxin levels closely during concurrent antibiotic–digoxin therapy, which can precipitate toxicity because of altered intestinal flora.
Observe patients closely when being transferred from one preparation (tablet, elixir, or parenteral) to another; when tablet is replaced by elixir potential for toxicity increases since
30% of drug is absorbed.

dimacalijulmar — 2021-09-16 12:54:24 UTC

References

Kizior, R., Hodgson, B., Hodgson, K., & Witmer, J. Saunders nursing drug handbook.

Prentice Hall Nurse's Drug Guide. (2021). Retrieved 16 September 2021, from http://www.robholland.com/Nursing/Drug_Guide/

dimacalijulmar — 2021-09-16 12:54:45 UTC

AUF Honor Code

As an Angelenean who lives by the core values of pagiging mabuti, magaling at may malasakit sa kapwa, I hereby commit that I complete my academic work with integrity. This means that I shall accomplish my academic work without receiving or giving unauthorized assistance. My work also observes scholarly and intellectual standards, rules on proper citation of sources, and appropriate collection and use of data.

CAPTOPRIL 💊

dimacalijulmar — 2021-09-16 13:15:15 UTC

Video Reference

dimacalijulmar — 2021-09-16 13:20:13 UTC

Supplemental Video

dimacalijulmar — 2021-09-16 13:24:29 UTC