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Drug Study Captopril
Drug Study Captopril
Indications
Hypertension
Reduces the risk of death or development of CHF after myocardial infarction (MI)
Slows the progression of left ventricular dysfunction into overt heart failure
Mechanism of Action
ACE inhibitors also increase plasma rennin levels and reduce aldosterine levels. This is
due to the suppression of the rennin-angiotensin-aldosterone system resulting in
decreased serum concentrations of angiotensin I and aldosterone. The reduction of
angiotensin I leads to decreased aldosterone secretion and as a result small increases in
serum potassium may occur along with sodium and fluid loss.
Contraindications
1. Hypersensitivity
3. Pregnancy
Use cautiously in
1. Renal impairment
2. Hepatic impairment
3. Hypovolemia
4. Hyponatremia
5. Elderly patients
7. Surgery or anesthesia
8. Lactation
9. Children
Side Effects
1. Dizziness or lightheadedness
2. Fatigue
3. Headache
4. Insomnia
6. Cough
7. Hypotension
10. Diarrhea
11. Nausea
12. Proteinuria
13. Hyperkalemia
Nursing Management
1. Monitor blood pressure and pulse frequently during initial dose adjustment and
periodically during therapy. (for patients treated with hypertension)
2. For patients treated with CHF, monitor weight and assess patient routinely for resolution
of fluid overload. Signs of fluid overload are: peripheral edema, rales or crackles,
dyspnea, weight gain and jugular vein distention.
3. The nurse should keep in mind that Captopril may cause false-positive result for urine
acetone.
4. The drug should be administered 1 hour before or 2 hours after meals. It may be crushed
if the patient has difficulty swallowing.
5. Keep this medication in the container it came in, tightly closed, and out of reach of
children.
6. Store it at room temperature and away from excess heat and moisture (not in the
bathroom).
8. Inform the patient that Captopril tablets may have a slight sulfur odor (like rotten eggs).
9. Instruct the patient to notify the physician immediately when the following
manifestations are experienced:
chest pain
fainting
rash