Read Mosby's 2014 Nursing Drug Reference Online
Authors: Linda Skidmore-Roth
Canada only Side effects:
italics
= common;
bold
= life-threatening
Nurse Alert
(ol-meh-sar′tan)
Benicar
Func. class.:
Antihypertensive
Chem. class.:
Angiotensin II receptor (type AT
1
) antagonist
Blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II; selectively blocks the binding of angiotensin II to the AT
1
receptor found in tissues
Hypertension, alone or in combination with other antihypertensives
Hypersensitivity, pregnancy 2nd/3rd trimesters (D)
Precautions:
Pregnancy (C) 1st trimester, breastfeeding, children, geriatric patients, hepatic disease, CHF
• Adult:
PO
Single agent 20 mg/day initially in patients who are not volume depleted, may be increased to 40 mg/day if needed after 2 wk
• Child ≥6 yr/adolescents ≤16 yr weighing ≥35 kg:
PO
20 mg/day, may increase to max 40 mg/day after 2 wk
• Child ≥6 yr/adolescents ≤16 yr weighing 20-<35 kg:
PO
10 mg daily, may increase to max 20 mg/day after 2 wk
Available forms:
Tabs 5, 20, 40 mg
•
Without regard to meals, refrigerate susp and store up to 1 mo, shake susp before use
CNS:
Dizziness
, fatigue, headache, insomnia
CV:
Chest pain, peripheral edema, tachycardia
EENT:
Sinusitis, rhinitis, pharyngitis
GI:
Diarrhea
, abdominal pain
MS:
Arthralgia, pain
RESP:
Upper respiratory infection
, bronchitis
SYST:
Angioedema
Peak 1-2 hr; excreted in urine, feces; half-life 13 hr; protein binding 99%
Increase:
antihypertensive effects—other antihypertensives, diuretics
Increase:
hyperkalemia—potassium supplements, potassium-sparing diuretics
Increase:
effect of lithium, antioxidants
Decrease:
antihypertensive effect—NSAIDs, colesevelan
Increase:
antihypertensive effect—hawthorn
Decrease:
antihypertensive effect—ephedra
Black Box Warning:
Pregnancy;
product can cause fetal death when given during pregnancy (D) 2nd/3rd trimesters
•
Response, adverse reactions, especially in renal disease
•
Hypertension:
B/P, pulse q4hr; note rate, rhythm, quality; electrolytes: sodium, potassium, chloride; baselines for renal, hepatic studies before therapy begins
•
Hypotension:
place supine, may occur with hyponatremia or those with volume depletion, more common in those taking a diuretic also
•
Therapeutic response: decreased B/P
•
To comply with dosage schedule, even if feeling better
•
To notify prescriber of mouth sores, fever, swelling of hands or feet, irregular heartbeat, chest pain
•
That excessive perspiration, dehydration, vomiting, diarrhea may lead to fall in B/P; to consult prescriber if these occur
•
That product may cause dizziness, fainting, lightheadedness
•
To rise slowly to sitting or standing position to minimize orthostatic hypotension
Black Box Warning:
To notify prescriber immediately if pregnant; not to use during breastfeeding
•
To avoid all OTC medications unless approved by prescriber
•
That blood glucose may increase and antidiabetic product may need dosage change
•
To inform all health care providers of medication use
•
To use proper technique for obtaining B/P, acceptable parameters
Canada only Side effects:
italics
= common;
bold
= life-threatening
Nurse Alert
See
Appendix B
See
Appendix B
(ohl-sal′ah-zeen)
Dipentum
Func. class.:
Antiinflammatory
Chem. class.:
Salicylate derivative
Do not confuse:
olsalazine
/OLANZapine
Bioconverted to 5-aminosalicylic acid, which decreases inflammation
Maintenance of remission of ulcerative colitis in patients intolerant to sulfasalazine
Hypersensitivity to this product or salicylates
Precautions:
Pregnancy (C), breastfeeding, children <14 yr; impaired renal/hepatic function; severe allergy; bronchial asthma
• Adult:
PO
500 mg bid, max 3 g/day
Available forms:
Caps 250 mg
•
Total daily dose evenly spaced to minimize GI intolerance, give with food
CNS:
Headache, hallucinations, depression, vertigo, fatigue, dizziness
GI:
Nausea, vomiting, abdominal pain,
hepatitis,
diarrhea, bloating, pancreatitis
HEMA:
Leukopenia, neutropenia, thrombocytopenia, agranulocytosis, anemia
INTEG:
Rash, dermatitis, urticaria
Partially absorbed, peak 1½ hr, half-life 30-90 min (rectal), 2-15 hr (PO), excreted in urine as 5-aminosalicylic acid and metabolites, crosses placenta
Increase:
azaTHIOprine toxicity—azaTHIOprine
Increase:
myelosuppression—mercaptopurine, thioguanine
Increase:
PT, INR—warfarin
Increase:
AST, ALT
•
Colitis:
bowel pattern, number of stools, consistency, frequency, pain, mucus before treatment and periodically
Blood dyscrasias:
skin rash, fever, sore throat, bruising, bleeding, fatigue, joint pain (rare); CBC before treatment and periodically
•
Allergic reaction:
rash, dermatitis, urticaria, pruritus, dyspnea, bronchospasm; allergy to salicylates
•
Storage in tight, light-resistant container at room temp
•
Therapeutic response: absence of fever, mucus in stools, decreased diarrhea, abdominal pain
•
To report diarrhea, rash, bleeding, bruising, fever, hallucinations
•
That product may cause dizziness; to avoid hazardous activities until reaction is known
•
To take even if feeling better; to take as directed; to take missed dose when remembered; but not to double
Canada only Side effects:
italics
= common;
bold
= life-threatening
Nurse Alert