Drug Study on

Nifedimine

In Partial Fulfillment of the Requirements

In NCM 207-RLE

OB Gyne Nursing

Submitted to:

Mrs.Rodelie B. Gulle, RN

Clinical Instructor

Submitted by:

Padilla, John Andrew

BSN 2D – GROUP 5

JANUARY 28, 2021

 I. Generic name: Nifedipine
II. Brand name: Adalat CC,
Procardia XL
III. Drug Classification:
PHARMACOTHERAPEUTIC:
Calcium channel blocker.
CLINICAL: Antianginal,
antihypertensive
IV. Prengnany Catergory:
Category C
V. Suggested dose and administration:

Available Forms:

 Capsule(immediate-release): 10m, 30mg

o ADULTS, ELDERLY: Initially, 10 mg 3 times/day. Increase at 7-
to 14-day intervals. Maintenance: 10 mg 3 times/day up to 30
mg 4 times/day. Maximum: 180 mg/day.
o Infant, Children and adolescent: doses range from 0.2 to 0.5
mg/kg/dose up to 10 mg total dose PO. Doses may be repeated
every 4 to 6 hours
 Tablet (extenden-release ) : 30mg, 60mg , 90 mg
o ADULTS, ELDERLY: Initially, 30–60 mg/day. May increase at 7-
to 14-day intervals. Maximum: 120–180 mg/day
o Children adolescence: Initial doses ranging from 0.25 to 0.5
mg/kg/day PO have been suggested. Titration as needed up to
a maximum of 3 mg/kg/day PO, not to exceed 120 mg/day

Route of administration:

 PO (tablet)
o Do not break, crush, dissolve, or divide extended-release
tablets.
 o Give without regard to meals (Adalat CC, Nifediac CC should be
taken on an empty stomach).
o Grapefruit products may alter absorption; avoid use.
 Sublingual (capsule)
o Capsules must be punctured, chewed, and/or squeezed to
express liquid into mouth.
I. Mode of action:
Inhibits calcium ion movement across cell membranes, depressing
contraction of cardiac, vascular smooth muscle. Therapeutic Effect:
Increases heart rate, myocardial oxygen delivery, cardiac output.
Decreases systemic vascular resistance, B/P.
II. Indication
Artery spasm (Prinzmetal’s variant angina), chronic stable angina
(effort-associated angina). Extended-release: Treatment of hypertension.
OFF-LABEL: Treatment of Raynaud’s phenomenon, pulmonary
hypertension, preterm labor, prevention/treatment of high-altitude
pulmonary edema.
III. Contraindication

Cardiogenic shock, concomitant administration with strong CYP3A4

inducers (e.g., rifampin), acute MI. Immediate-Release: Treatment of
urgent/emergent hypertension. Cautions: Renal/hepatic impairment,
obstructive coronary disease, HF, severe aortic stenosis, edema, severe
left ventricular dysfunction, hypertrophic cardiomyopathy, concurrent use
with beta blockers or digoxin, CYP3A4 inhibitors/inducers.

VI. Side effect:

Frequent (30%–11%): Peripheral edema, headache, flushed skin,

dizziness. Occasional (12%–6%): Nausea, shakiness, muscle cramps/pain,
drowsiness, palpitations, nasal congestion, cough, dyspnea, wheezing. Rare
(5%–3%): Hypotension, rash, pruritus, urticaria, constipation, abdominal
discomfort, flatulence, sexual dysfunction.
VII. Adverse effects:

May precipitate HF, myocardial infraction in pts with cardiac disease,

peripheral ischemia. Overdose produces nausea, drowsiness, confusion, slurred
speech. Antidote: Glucagon

IV. Drug Interaction:

Strong CYP3A4 inducers (e.g., rifampin, phenobarbital, phenytoin,

carbamazepine) may decrease concentration/effects. CYP3A4 inhibitors (e.g.,
clarithromycin, ketoconazole) may increase concentration. Beta blockers may
have additive effect. May increase digoxin concentration, risk of toxicity.
Hypokalemia-Â producing agents (e.g furosemide, other diuretics) may increase
risk of arrhythmias. HERBAL:Ephedra, garlic, ginseng, yohimbe may increase
hypertension. Licorice may cause retention of sodium, water; may increase loss of
potassium. St. John’s wort decreases concentration/effects.

FOOD: Grapefruit products may increase risk for flushing, headache,

tachycardia, and hypotension. LAB VALUES: May cause positive ANA, direct
Coombs’ tes

V. Nursing Consideration

BASELINE ASSESSMENT

Concurrent therapy with sublingual nitroglycerin may be used for

relief of anginal pain. Record onset, type (sharp, dull, squeezing), radiation,
location, intensity, duration of anginal pain; precipitating factors (exertion,
emotional stress). Check B/P for hypotension immediately before giving
medication.

INTERVENTION/EVALUATION

Assist with ambulation if light-headedness, dizziness occurs.

Assess for peripheral edema. Assess skin for flushing. Monitor LFT.
Observe for signs/symptoms of HF.
 PATIENT/FAMILY TEACHING

• Go from lying to standing slowly.

• Report palpitations, shortness of breath, pronounced

dizziness,nausea,exacerbations of angina.

• Avoid alcohol; concomitant grapefruit product use.

References:

Kizior, R. J., Hodgson, K. J., Hodgson, B. B., & Witmer, J. B. (2016). Saunders
nursing drug handbook.

Sanjai Sinha, MD (2020). Nifedipine. https://www.drugs.com/nifedipine.html