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Drug Information Table
ACE Inhibitors – captopril (Capoten)
THERAPEUTIC USE • Treatment of
• Hypertension
• Heart failure (HF)
• Diabetic nephropathy
• Left ventricular dysfunction following myocardial infarction (ramipril)
ADVERSE DRUG • Severe hypotension following first dose (most likely in clients taking
REACTIONS diuretics, with high BP, or who have hyponatremia)
• Dry, nonproductive cough due to increase in bradykinin
• Rash and report of metallic taste in mouth
• Angioedema (swelling of mouth, throat due to inhibition of kinase II)
• Hyperkalemia
• Neutropenia (decrease in white blood cells with increased risk of
infection)
INTERVENTIONS • Start ACE inhibitors with low dose and gradually increase to prevent
hypotension
• Diuretics may be temporarily stopped before first dose of ACE inhibitor
is given
• Monitor BP following first dose
• Manage severe hypotension by expanding blood volume with IV fluid
therapy
• Monitor for and report dry cough
• Discontinue use of ACE inhibitor if dry cough occurs
• Monitor for and report these effects (ACE inhibitor may be
discontinued)
• Treat severe angioedema with IV epinephrine
• Discontinue use of any ACE inhibitor if angioedema occurs
• Monitor potassium levels in clients who are at risk (See interactions,
below)
• Monitor white blood cell counts (WBC) with differential (includes
number of neutrophils and other types of white blood cells) every 2
weeks for first 3 months of therapy and then periodically
ADMINISTRATION • Available for oral use only
• Must be taken two to three times daily for hypertension; three times
daily for heart failure
• Give captopril 1 hr before meals for adequate absorption
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DRUG INFORMATION TABLE
CLIENT • Be aware of the effects that may occur
INSTRUCTIONS
• Lie supine if lightheadedness occurs following first dose
• Report dry cough to provider
• Report rash to provider
• Report metallic or decreased ability to taste foods associated with
decreased intake and weight loss
• Report minor swelling of mouth, throat to provider; call 911
immediately if severe reaction occurs
• Refrain from using potassium supplements and potassium-containing
salt substitutes while taking an ACE inhibitor
• Report palpitations, muscle twitching, weakness or paresthesia in
extremities to provider
• Report sore throat or other signs of infection to provider
• Do not take an ACE inhibitor if you are pregnant or breastfeeding
CONTRAINDICATIONS • Teratogenic effects
• Angioedema or allergy to ACE inhibitors
• Hypotension
• Liver disease with elevated liver enzymes
PRECAUTIONS • Decreased renal function
• Bone marrow depression or use of other drugs that cause
immunosuppression
• Auto immune disorders, such as rheumatoid arthritis
• Cardiovascular disease
• Cerebral vascular disease
• Heart failure
• Hyperkalemia
• Hyponatremia
• Older adults
• Less effective in African American clients
INTERACTIONS • Potassium-sparing diuretics, potassium supplements, or use of salt
substitutes increase risk for hyperkalemia
• Antihypertensive drugs, diuretics, and nitrates (such as nitroglycerin)
increase risk for hypotension
• NSAIDs may decrease effectiveness
• Food decreases absorption of ACE inhibitors
• ACE inhibitors may cause lithium toxicity
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Drug Information Table
Adrenergic neuron blockers – reserpine
THERAPEUTIC USE • Treats hypertension (not a first-line choice due to severe adverse
effects)
ADVERSE DRUG • Severe depression and risk for suicide, which can linger after reserpine
REACTIONS is discontinued
• Bradycardia and orthostatic hypotension
• GI symptoms: diarrhea, abdominal cramping
INTERVENTIONS • Carefully monitor for and report signs of depression to provider
• Ensure that lowest possible dosage of reserpine is being given
• Monitor pulse rate and B/P
• Assist with ambulation as needed
• Monitor for and report severe or prolonged GI effects
ADMINISTRATION • Available for oral use only
• Administer with food or milk to prevent GI symptoms
CLIENT • Report feelings of depression, including insomnia and loss of appetite
INSTRUCTIONS or interest in daily activities to provider
• Do not perform dangerous activities, such as driving, until effects are
known
• Move slowly from lying down to sitting and standing to prevent falling
• Report dizziness, syncope to provider
• Report prolonged or severe GI effects to provider
CONTRAINDICATIONS • Previous allergy to rauwolfia alkaloids
• Depressive disorders
• Peptic ulcer or ulcerative colitis
PRECAUTIONS • Cardiac dysrhythmias, or cerebrovascular disease
• History of peptic ulcer
• Older adults
INTERACTIONS • Antihypertensive drugs can increase risk for hypotension
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Find more resources on this topic on
,dmuwodmfdmuwodmfdmuwodmf-80aca8f76992007cae14fc4266c24b37
Drug Information Table
ACE Inhibitors – captopril (Capoten)
THERAPEUTIC USE • Treatment of
• Hypertension
• Heart failure (HF)
• Diabetic nephropathy
• Left ventricular dysfunction following myocardial infarction (ramipril)
ADVERSE DRUG • Severe hypotension following first dose (most likely in clients taking
REACTIONS diuretics, with high BP, or who have hyponatremia)
• Dry, nonproductive cough due to increase in bradykinin
• Rash and report of metallic taste in mouth
• Angioedema (swelling of mouth, throat due to inhibition of kinase II)
• Hyperkalemia
• Neutropenia (decrease in white blood cells with increased risk of
infection)
INTERVENTIONS • Start ACE inhibitors with low dose and gradually increase to prevent
hypotension
• Diuretics may be temporarily stopped before first dose of ACE inhibitor
is given
• Monitor BP following first dose
• Manage severe hypotension by expanding blood volume with IV fluid
therapy
• Monitor for and report dry cough
• Discontinue use of ACE inhibitor if dry cough occurs
• Monitor for and report these effects (ACE inhibitor may be
discontinued)
• Treat severe angioedema with IV epinephrine
• Discontinue use of any ACE inhibitor if angioedema occurs
• Monitor potassium levels in clients who are at risk (See interactions,
below)
• Monitor white blood cell counts (WBC) with differential (includes
number of neutrophils and other types of white blood cells) every 2
weeks for first 3 months of therapy and then periodically
ADMINISTRATION • Available for oral use only
• Must be taken two to three times daily for hypertension; three times
daily for heart failure
• Give captopril 1 hr before meals for adequate absorption
Assessment Technologies Institute: Pharmacology Made Easy 4.0 1
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,dmuwodmfdmuwodmfdmuwodmf-80aca8f76992007cae14fc4266c24b37
DRUG INFORMATION TABLE
CLIENT • Be aware of the effects that may occur
INSTRUCTIONS
• Lie supine if lightheadedness occurs following first dose
• Report dry cough to provider
• Report rash to provider
• Report metallic or decreased ability to taste foods associated with
decreased intake and weight loss
• Report minor swelling of mouth, throat to provider; call 911
immediately if severe reaction occurs
• Refrain from using potassium supplements and potassium-containing
salt substitutes while taking an ACE inhibitor
• Report palpitations, muscle twitching, weakness or paresthesia in
extremities to provider
• Report sore throat or other signs of infection to provider
• Do not take an ACE inhibitor if you are pregnant or breastfeeding
CONTRAINDICATIONS • Teratogenic effects
• Angioedema or allergy to ACE inhibitors
• Hypotension
• Liver disease with elevated liver enzymes
PRECAUTIONS • Decreased renal function
• Bone marrow depression or use of other drugs that cause
immunosuppression
• Auto immune disorders, such as rheumatoid arthritis
• Cardiovascular disease
• Cerebral vascular disease
• Heart failure
• Hyperkalemia
• Hyponatremia
• Older adults
• Less effective in African American clients
INTERACTIONS • Potassium-sparing diuretics, potassium supplements, or use of salt
substitutes increase risk for hyperkalemia
• Antihypertensive drugs, diuretics, and nitrates (such as nitroglycerin)
increase risk for hypotension
• NSAIDs may decrease effectiveness
• Food decreases absorption of ACE inhibitors
• ACE inhibitors may cause lithium toxicity
2 Assessment Technologies Institute: Pharmacology Made Easy 4.0
Discuss this document with others on
, dmuwodmfdmuwodmfdmuwodmf-80aca8f76992007cae14fc4266c24b37
Drug Information Table
Adrenergic neuron blockers – reserpine
THERAPEUTIC USE • Treats hypertension (not a first-line choice due to severe adverse
effects)
ADVERSE DRUG • Severe depression and risk for suicide, which can linger after reserpine
REACTIONS is discontinued
• Bradycardia and orthostatic hypotension
• GI symptoms: diarrhea, abdominal cramping
INTERVENTIONS • Carefully monitor for and report signs of depression to provider
• Ensure that lowest possible dosage of reserpine is being given
• Monitor pulse rate and B/P
• Assist with ambulation as needed
• Monitor for and report severe or prolonged GI effects
ADMINISTRATION • Available for oral use only
• Administer with food or milk to prevent GI symptoms
CLIENT • Report feelings of depression, including insomnia and loss of appetite
INSTRUCTIONS or interest in daily activities to provider
• Do not perform dangerous activities, such as driving, until effects are
known
• Move slowly from lying down to sitting and standing to prevent falling
• Report dizziness, syncope to provider
• Report prolonged or severe GI effects to provider
CONTRAINDICATIONS • Previous allergy to rauwolfia alkaloids
• Depressive disorders
• Peptic ulcer or ulcerative colitis
PRECAUTIONS • Cardiac dysrhythmias, or cerebrovascular disease
• History of peptic ulcer
• Older adults
INTERACTIONS • Antihypertensive drugs can increase risk for hypotension
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