Miki - Ramipril Flashcards
Drug names
Generic - ramipril
Trade - Altace
Drug classes
Therapeutic - antihypertensive
Pharmacological - ACE inhibitor
Indications
Management of hypertension
Reduction of risk of MI, stroke
Reduction of risk of heart failure progression following MI
Action
Angiotensin conversing enzyme (ACE) inhibitors block conversion of angiotensin I into II.
They prevent degradation of bradykinin and other vasodilators.
They raise plasma renin levels and lower aldosterone
Therapeutic effects
Lowering BP in hypertensive patients
Decreases risk of MI/stroke
Contra indications
Hypersensitivity
History of angioedema with previous ACE inhibitor use
Use cautiously in:
- black patients
- renal impairment
- Geri (lower initial dose)
- post surgery
EXTREME CAUTION
- family history of angioedema
Adverse affects
Frequent: hypotension, cough
Angioedema
Angioedema
Sudden swelling beneath skin surface and fatty tissue
Safe dose
Miki is taking to reduce stroke risk
Safe dose: 2.5mg/d, raised to 5 after a week, then 10 after 3 weeks
Why is miki taking this
Decrease the risk of stroke and MI
Side effects seen in miki
Dizziness? Fatigue?
Miki and this drug
Dysphagia
Orthostatic hypotension
- be careful sitting up
Miki is taking ASA
- may blunt the antihypertensive effect
- increase risk of renal dysfunction
Taking Timoptic
Concurrent use of angiotensin II blockers can increase adverse affect risk
Nursing actions
Monitor BP ac/pc
Monitor weight
Assess for signs of angioedema
(Swelling of face eyes lips, etc)
Assess for rash
Note urine output (renal function)
Give at the same time each day
What does miki need to know
This will help prevent another stroke
