BAUTISTA, Jesther Rowen B.


BSN IV-1 USE OF DRUG CLASSIFICATIONS: y Calcium channel-blocker y Antianginal y Antihypertensive INDICATIONS: y Hypertension y Chronic stable angina y Angina pectoris due to coronary artery spasm y CONTRAINDICATIONS: y Hypersensitivity to Nifedipine y pregnant and lactating mothers

BDH, ER/DR 11-7 MECHANISM OF ACTION Inhibits the movement of calcium ions across the membranes of cardiac and arterial muscle cells; inhibition of transmembrane calcium flow results in the depression of impulse formation in specialized cardiac pacemaker cells, in slowing of the velocity of conduction of the cardiac impulse, in the depression of myocardial contractility, and in the dilation of coronary arteries and arterioles and peripheral arterioles; these effects lead to decreased cardiac work, decreased cardiac energy consumption, and increased delivery of oxygen to myocardial cells. SIDE EFFECTS y CNS: Dizziness, lightheadedness, headache, asthenia, fatigue, nervousness, sleep disturbances, blurred vision y C V:Peripheral edema, angina, hypotension, arrhythmias, AV block, asystole y Dermatologic: Flushing, rash, dermatitis, pruritus, urticaria y GI: Nausea, diarrhea, constipation, cramps, flatulence, hepatic injury y Other: Nasal congestion, cough, fever, chills, shortness of breath, muscle cramps, joint stiffness, sexual difficulties NURSING CONSIDERATIONS ASSESSMENT y History: Allergy to nifedipine; pregnancy; lactation y Physical: Skin lesions, color, edema; orientation, reflexes; P, BP, baseline ECG, peripheral perfusion, auscultation; R, adventitious sounds; liver evaluation, normal GI output; liver function tests INTERVENTIONS y Monitor patient carefully (BP, cardiac rhythm, and output) while drug is being adjusted to therapeutic dose; the dosage may be increased more rapidly in hospitalized patients under close supervision. Do not exceed 30 mg/dose increases. y Taper dosage of betablockers before nifedipine therapy. y Protect drug from light and moisture. y Report irregular heartbeat, shortness of breath, swelling of the hands or feet, pronounced dizziness, constipation.

Nifedipine 20mg PO TID

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