DRUG STUDY

GENERIC NAME AND TRADE NAME
Generic name: Amlodipine

CLASSIFICATION
Anti –hypertensive; calcium channel blockers

INDICATION AND CONTRAINDICATION
Indication: Alone or with other agents in the management of hypertension, angina pectoris, vasospatic angina. Contraindication: Contraindicated in: hypersensitivity; systolic blood pressure <90 mmHg. Use cautiously in: severe hepatic impairment (dosage reduction recommended); aortic stenosis; history of CHF; OB, lactation, Pedi: safety not established; Geri: dose reduction recommended;  risk of hypotension

FREQUENCY, ROUTE AND DOSAGE
PO (Adults): 5-10 mg once daily; anti –hypertensive in fragile or small patients or patients already receiving other anti –hypertensive – initiate at 2.5 mg/day,  as required/tolerated (up to 10 mg/day) as anti – hypertensive therapy with 2.5 mg/day in patients with hepatic insufficiency PO (Geriatric Patients): anti – hypertensive initiate therapy at 2.5 mg/day,  as required/tolerated (up to 10 mg/day); antianginal –initiate therapy at 5 mg/day,  as required/tolerated (up to 10 mg/day).

SIDE EFFECTS AND ADVERSE EFFECTS CNS: headache,dizziness,fatigue. CV: Peripheral edema, angina, bradycardia, hypotension, palpitations. GI: Gingival hyperplasia, nausea. DERM: flushing

NURSING RESPONSIBILITIES
 Alert: monitor patient carefully. Some patients, especially those with severe coronary obstructive disease, have developed frequency, duration, or severity of angina or acute MI after initiation of calcium channel blocker therapy or at time of dosage increase. Monitor blood pressure frequently during initiation of therapy. Because drug induced vasodilation has a gradual onset, acute hypotension is rare. Notify prescriber if signs of heart failure occur, such as swelling of hands and feet or shortness of breath.

Trade name: Norvasc

Generic name: Clonidipine Trade name: Catapres , Catapres-TTS, Dixarit, Duraclon

Antihypertensives; adrenergics

Indication: PO, Transdermal: Management of mild to moderate hypertension. Epidural: Management of cancer pain unresponsive to oploids alone. Unlabeled Use: Management of oploid withdrawal. Treatment of attention-deficit hyperactivity disorder (ADHD). Adjunctive treatment of neuropathic pain. Contraindication: Contraindicated in: Hypersensitivity; Epidural – injection site infection, anticoagulant therapy or bleeding problems. Use Cautiously in: Serious cardiac or cerebrovascular disease; Renal insufficiency; Pedi: Evaluation of cardiac disease should precede initiation of therapy for ADHD in children; Geri: Appear on Beers list due to increased risk of orthostatic hypotension and adverse CNS effects in geriatric patients( dose recommended); OB, Lactation: Safety not established.