DRUG NAME Generic Name: AMLODIPINE Brand Name: Norvasc Classification: Calcium channelblocker, Antianginal, Antihypertensive Pregnancy Category

C Patients Dose/Route: 5mg tab OD

THERAPEUTIC OF ACTIONS Inhibits the movement of calcium ions across the membranes of cardiac and arterial muscle cells; inhibits transmembrane calcium flow, which result in the depression of impulse formation in specialized cardiac pacemaker cells, slowing of the velocity of conduction of the cardiac impulse, depression of the myocardial contractility, and dilation of the coronary arteries and arterioles; these effects lead to decreased cardiac work, decrease cardiac oxygen consumption, and in patients with vasospastic (Prinzmentals) angina, increase delivery of oxygen to cardiac cells.

INDICATIONS Angina pectoris due to coronary artery spasm (Prinzmetals variant angina) Chronic stable angina, alone or in combination with other drugs Essential hypertension, alone or in combination with other antihypertensives

ADVERSE EFFECTS CNS: Dizziness, light-headedness, fatigue CV: Peripheral Edema Dermatologic: Flushing, rash GI: Nausea, abdominal discomfort

CONTRAINDICATIONS/ PRECAUTIONS Contraindicated with allergy to amlodipine, impaired hepatic or renal function, lactation Use cautiously with CHF, pregnancy

NURSING CONSIDERATIONS Assessment History: Allergy to amlodipine, impaired hepatic or renal function, lactation, CHF Physical: Skin lesions, color, edema; P, BP, baseline ECG, auscultation; R, adventitious sounds; liver evaluation, GI normal output; renal function tests, urinalysis Interventions WARNING: Monitor patient carefully (BP, cardiac rhythm, and output) while adjusting drug to therapeutic dose; use special caution if patient has CHF. Monitor BP very carefully if patient is also on nitrates. Monitor cardiac rhythm regularly during stabilization of dosage and periodically during long-term therapy. Administer drug without regard to meals. Teaching points Take with meals if upset stomach occurs. You may experience these side effects: Nausea, vomiting (eat frequent small meals); headache (adjust lighting, noise, and temperature; medication may be ordered). Report irregular heartbeat, shortness of breath, swelling of the hands or feet, pronounced dizziness, constipation.