CARDIAC DRUGSDefine How They Work Overall: ‘* Stops conversion of angiotension I to angiotensin If to cause a drop in peripheral vascular resistance. End result is vasodilation. Also, can increase renal blood flow by dilating efferent arteriole of nephron Hints To Help Remember: * PRIL ending. You're an ACE if you get your taxes done in APRIL. ‘Examples: + Enalapril (Vasotec) ‘+ Captopril (Capoten) * Benazepril (Lotensin) «Lisinopril (Prinivil, Zestril) ‘+ Quinaprit (Accupril) * Moexipril (Univase) + Ramiprl (Altace) Nursing considerations with Rationale: * May have to instruct client to stay in bed for 3 hrs after 1* initial dose. Rationale: Severe hypotension may follow the first dose * Monitor BP before, during and after administration. Monitor orthostatic BP periodically and assess for dizziness. Teach patient to slowly rise from lying to sitting position. Use cautiously with actoRationale: Hypotension needs to be recognized quickly and responded to. Reduce postural hypotensive effects. When rennin suppressed, then fluid volume deficit can occur. “Monitor for dry cough Rationale: Prevents rennin from forming and this can effect the lungs by producing a dry cough. A dry cough is a common side effect of ACE inhibitors. Obtain baseline BUN, creatinine lab values and urine protein levels. ‘Monitor for elevated BUN/Creatinine levels and protein in the urine ‘Monitor weight and electrolytes. Rationale: ACE inhibitors can impact the kidneys and patients can go into acute tubular necrosis within 24 hrs of administration. ‘Hyperkalemia can occur, especially when used concurretly with potassium sparing diuretics. Side note here: evidence based research. is indicating that diabetic patients should be on ACE inhibitors to protect kidneys. Monitor salt intake and foods rich in K+ Rationale: Increasing salt in diet can lead to more water retention and ‘can counter act effects of ACE inhibitors. Monitor for skin rash Rationale: Can decrease WBC levels Give on empty stomach if possible Rationale: sbsorbed the best if given on an empty stomach