9/13/2016
CaptoprilDrugStudy
Captopril Drug Study
By Melvin Baltazar RN - Jan 25, 2013
http://rnspeak.com/drugstudy/captoprildrugstudy/
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CaptoprilDrugStudy
GenericName:Captopril
BrandNames:Capoten,Acepril,AceBloc,BlocMed,Capomed,Capotec,Captogen,Captor,Captril,
Cardiovaz
Classification:ACEInhibitor
PregnancyCategory:D
Route:Oral
Preparations:12.5,25,50,100mg
Indication:Captoprilisusedaloneorincombinationofotherdrugsforthemanagementof
hypertension.Itisalsousedincombinationwithotherdrugsinthetreatmentofheartfailureaftera
heartattack.Alsousedtotreatkidneyproblemscausedbydiabeticnephropathy.
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Contraindications:AllergytootherACEinhibitors.Aorticstenosis,outflowobstruction,
renovasculardisease.PregnancyandLactation.CautionincaseswherepatientsalsohaveLeukemia,
COPD,renalorthyroiddisease.
Action:Usedtoblocktheactionofangiotensinconvertingenzyme(ACE)whichisnaturally
producedinthebody.ACEproducesangiotensinIIwhichcausesconstrictionandnarrowingofthe
bloodvesselstherebyincreasingbloodpressure.ByblockingACE,productionofangiotensinII
decreasesallowingthebloodvesselstorelaxandwidenresultingindecreasebloodpressure.
TherapeuticEffect:Lowersbloodpressureandincreasesbloodandoxygensupplytotheheartin
patientswithhypertension.Decreasespreloadandafterloadforpatientswithheartfailure.Slows
downorreducesprogressionofbloodvesselsdiseasewithinthekidneycausedbyhighblood
pressureinpatientswithdiabeticnephropathy.
Dosage:Hypertension:Initialdoseof12.5mgtwiceaday,increasegraduallyat24wkinterval.
Maintenancedoseof2550mgtwiceaday,maximumof50mgthriceaday.HeartFailure:Initial
doseof6.25mg12.5mg.Maintenancedoseof25or50mgbid,maximumdoseof50mgtid.
DiabeticNephropathy:75100mgdailyindivideddoses.
Pharmacokinetics:
Absorption:Rapidlyabsorbed(75%)fromtheGItract.Fooddecreasesabsorption.
Distribution:Widelydistributedbutdoesnotcrossthebloodbrainbarrier.Crossestheplacenta,
smallamountsenterbreastmilk.
MetabolismandExcretion:50%metabolizedbytheliver.50%excretedunchangedbythekidneys.
Pharmacodynamics:
Onset:1560min
Peak:6090min
Duration:612hr
SideEffects:hypotension,dizziness,drymouth,itching,sleepproblems,rashes,diarrhea,
constipation,hairloss,dryirritatingcough,changesinthewaythingstaste,upsetstomach,
abdominalpain,shortnessofbreath,agranulocytosis,neutropenia
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Interactions:Additivehypotensionwithotherantihypertensive,phenothiazines,acuteingestionof
alcoholandvasodilators.Hyperkalemiamayresultfromconcurrentuseofpotassiumsupplementsor
potassiumsparingdiuretics,Antihypertensiveresponsemaybebluntedbynonsteroidalanti
inflammatoryagents.Absorptionmaybedecreasedbyantacids.Increaseslevelsandmayincrease
riskofdigoxinorlithiumtoxicity.Probeneciddecreaseseliminationandincreaseslevelsofcaptopril.
Riskofhypersensitivityreactionsincreasedbyconcurrentuseofallopurinol.
NursingConsiderations
Monitorbloodpressureandpulsefrequently.
Monitorweightandassessespatientfrequentlyforsignsoffluidoverloadifwithconcurrent
diuretictherapy.
assessmentsofurineproteinmaybeordered.Proteinuriaandnephroticsyndromemayoccur
withtherapy.
MonitorBUN,Creaandelectrolytelevelsperiodically.
WBCshouldbemonitoredpriortotherapyandperiodicallythereafter.
Maycausefalsepositiveresultforurineacetone
Patient/FamilyHealthTeachings
Instructpatienttotakecaptoprilexactlyasdirected.Misseddoseshouldbetakenassoonas
rememberedbutnotifalmosttimefornextdose.
Donotdoubledoses.
Instructpatientnottodiscontinuecaptopriltherapyunlessdirectedbyhealthcareprovider.
Encouragepatienttocomplywithadditionalinterventionsforhypertension.
Instructpatientandfamilyonpropertechniqueofbloodpressuremonitoring.Advicethemto
checkbloodpressureatleastweeklyandtoreportanysignificantchanges.
Cautionpatienttoavoidfoodscontaininghighlevelsofsodiumorpotassium.
Advicepatientthatanychangesintastesensationwillreverseitselfwithin812weeks.
Instructpatienttochangepositionslowlytominimizeoccurrenceoforthostatichypotension.
Advicepatientthatexercisinginhotweathermayincreasehypotensiveeffect.
Instructpatienttoconsultwithahealthcareproviderbeforetakinganyoverthecounter
medicationsorcoldremedies.
Advicepatientofingestingexcessiveamountoftea,coffeeorcola.
Advicepatienttoavoiddrivingorotheractivitiesthatrequirealertnessuntilresponsetotherapy
isknown.
Instructpatienttonotifyhealthcareproviderifrash,sorethroat,fever,irregularheartbeat,
chestpain,swellingofface,eyes,lipsortongueanddifficultyofbreathingoccurs.
Emphasizeimportanceoffollowupexaminationsformonitoringpurposes.
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NursingDiagnosis:
DecreasedCardiacOutput
Knowledgedeficitrelatedtomedicationregimen
Noncompliance
Melvin Baltazar RN
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