Captopril

dr.joandr.joan عضو ماسي
تم تعديل 2009/06/25 في أدوية الطوارئ Emergency drugs
5. Captopril:
Trade name: Capotin, nhabace
Class: antihypertensive, inhibitor of angiotensin synthesis.
Pregnancy: (Category C)

Action:
· Captopril is a highly specific competitive inhibitor of angiotensin I Converting enzyme.
· The enzyme is responsible for the conversion of angiotensin I to angiotensin II which decrease BP.
· Reduce peripheral arterial resistance.
· Decrease aldosterone secretion which works to increase level of serum potassium.
Uses:
· Hypertension.
· In combination with diuretics and digitalis in the treatment of CHF.
Dose
hypertension, used alone, initially 12.5 mg twice daily; if used in addition to diuretic, or in elderly, initially 6.25 mg twice daily (first dose at bedtime); usual maintenance dose 25 mg twice daily; max. 50 mg twice daily (rarely 3 times daily in severe hypertension)
Heart failure (adjunct), initially 6.25–12.5 mg under close medical supervision; usual maintenance dose 25 mg 2–3 times daily; usual max. 150 mg daily
Prophylaxis after infarction in clinically stable patients with asymptomatic or symptomatic left ventricular dysfunction, initially 6.25 mg, starting as early as 3 days after infarction, then increased over several weeks to 150 mg daily (if tolerated) in divided doses .
Contraindications:

· Hypersensitivity, Reno vascular disease and pregnancy.


Side effects:
· Skin rash, loss of taste, neutropnea, nausea, vomiting,
· Hypotension, proteinuria, renal failure and hyperkalemia.

Nursing considerations:
· In case of overdose, give normal saline to restore BP.
· Should not be discontinued without Dr. Instructions.
· Obtain baseline hematological studies, liver & renal functions tests prior to beginning the treatment.
· Determine client understands of the therapy and if he/she takes other medications.
· Observe client closely for hypotension 3 hours after the initial dose.
· In case of hypotension, place client in supine position and give IV saline infusion.
· Withhold potassium sparing diuretics and consult with physician (hyperkalemia may occur).
· Take captopril 1 hour before meal or on an empty stomach.
· Report skin rash, heartburn, and chest pain to physician.
· Explain to client that he may develop loss of taste for 2-3 months, if it persists, notify the physician.