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Prinivil Lisinopril

Prinivil Lisinopril

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Published by Cassie

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Published by: Cassie on Oct 15, 2008
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NURS 2516 Clinical Medications Worksheets
(You will need to make additional copies of these forms)Generic Name
Trade Name
ACE Inhibitors
10 mgDosage range: 10 mg once daily, can be increased upto 20-40 mg/day (initiate therapy at 5 mg/day in patients receiving diuretics).
6 hr 
1 hr 
24 hours
For IV meds, compatibility with IV drips and /or solutions N/AMechanism of action and indications(Why med ordered)
Angiotensin-converting enzyme (ACE) inhibitors block theconversion of angiotensin I to the vasoconstrictor angiotensin II.ACE inhibitors also prevent the degradation of bradykinin andother vasodilatory prostaglandins. ACE inhibitors also increase plasma renin levels and reduce aldosterone levels. Net result issystemic vasodilation. Indicated for the treatment of hypertention.My patient is receiving this med for Hypertension.
Nursing Implications (what to focus on)
 pt’s w/
Hypersensitivity and history of angioedema with previous use of ACE inhibitors. Use cautiously in pt’s w/ Renal impairment,hypovolemia, hyponatremia, geriatric patients, concurrent diuretictherapy (initial dosage reduction recommended). Use extreme caution in pt’s w/ a family history of angioedema.
Common side effects
dizziness, cough,hypotension, n/v/d, rashes, hyperkalemia, andangioedema
Interactions with other patient drugs, OTC or herbalmedicines (ask patient specifically)
Additive hypotension with other antihypertensive agents (Coregfor ex.)
Lab value alterations caused by medicine
Monitor BUN, creatinine, and electrolyte levels periodically. Serum potassium may be increased and BUN and creatinine transientlyincreased, whereas sodium levels may be decreased. If elevated BUN or serum creatinine concentrations occur, dosage reduction or withdrawalmay be required. Monitor CBC periodically during therapy in patientswith collagen vascular disease and/or renal disease. May rarely causeslight decrease in hemoglobin and hematocrit and agranulocytosis. Maycause elevated AST, ALT, alkaline phosphatase, and serum bilirubin.
Be sure to teach the patient the following about thismedication
Instruct patient to take exactly as directed at the same time each day, evenif feeling well. Missed doses should be taken as soon as possible but notif almost time for next dose. Do not double doses. Warn patient not todiscontinue ACE inhibitor therapy unless directed by health care professional. Caution patient to avoid salt substitutes containing potassium or foods containing high levels of potassium or sodium unlessdirected by health care professional. Caution patient to change positionsslowly to minimize hypotension, particularly after initial dose. Patientsshould also be advised that exercising in hot weather may increasehypotensive effects. Advise patient to consult health care professional before taking any OTC medications, especially cold remedies. May causedizziness. Caution patient to avoid driving and other activities requiringalertness until response to medication is known. Instruct patient to notifyhealth care professional if rash; mouth sores; sore throat; fever; swellingof hands or feet; irregular heart beat; chest pain; dry cough; hoarseness;swelling of face, eyes, lips, or tongue; or if difficulty swallowing or  breathing occurs. Persistent dry cough may occur and may not subsideuntil medication is discontinued. Consult health care professional if cough becomes bothersome. Also notify health care professional if nausea, vomiting, or diarrhea occurs and continues. Encourage patient tocomply with additional interventions for hypertension (weight reduction,low sodium diet, discontinuation of smoking, moderation of alcoholconsumption, regular exercise, and stress management).

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