Nifedepine Drug Study

Nifedipine

Brand Name: Adalat, Adalat CC, Adalat XL (CAN), Apo-Nifed (CAN), Gen-
Nifedipine (CAN), Nifedical XL, Novo-Nifedin (CAN), Procardia, Procardia XL

Pregnancy Category C

Drug classes: Calcium channel-blocker, Antianginal agent, Antihypertensive

Therapeutic actions
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.

Indications
Angina pectoris due to coronary artery spasm (Prinzmetal's variant angina)
Chronic stable angina (effort-associated angina)
Treatment of hypertension (sustained-release preparation only)
Orphan drug use: treatment of interstitial cystitis

Contraindications
Contraindicated with allergy to nifedipine; pregnancy.

Adverse effects
Dizziness, light-headedness, headache, asthenia, fatigue, nervousness, sleep
disturbances, blurred vision, Peripheral edema, angina, hypotension,
arrhythmias, AV block, asystole, Flushing, rash, dermatitis, pruritus, urticaria,
Nausea, diarrhea, constipation, cramps, flatulence, hepatic injury, Nasal
congestion, cough, fever, chills, shortness of breath, muscle cramps, joint
stiffness, sexual difficulties

Drug Interactions:
Increased effects with cimetidine

Nursing considerations
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.
Ensure that patients do not chew or divide sustained-release tablets.
Taper dosage of beta-blockers before nifedipine therapy.
Protect drug from light and moisture.