Generic Trade Name Classification Dose: 5 mg Route Time/frequency

Name Vasotec ACE Inhibitors Dosage range: 5mg q day, increased as required by PO Q AM
Enalaprill response. 10-40mg q day in 1-2 divided doses.
Peak Onset Duration For IV meds, compatibility with IV drips and /or solutions
4-6 hr 1 hr 24 hours N/A
Mechanism of action and indications Nursing Implications (what to focus on)
(Why med ordered) Contraindications/warnings/interactions
Angiotensin-converting enzyme (ACE) inhibitors block the pt’s w/ Hypersensitivity and history of angioedema with previous use of
conversion of angiotensin I to the vasoconstrictor angiotensin II. ACE inhibitors. Use cautiously in pt’s w/ Renal impairment,
ACE inhibitors also prevent the degradation of bradykinin and hypovolemia, hyponatremia, concurrent diuretic therapy (initial dosage
other vasodilatory prostaglandins. ACE inhibitors also increase reduction recommended). Use extreme caution in pt’s w/ a family history
plasma renin levels and reduce aldosterone levels. Net result is of angioedema.
systemic vasodilation. Indicated for the treatment of hypertention. Common side effects
dizziness, cough,hypotension, n/v/d, rashes, hyperkalemia, and
My patient is receiving this med for Hypertension. angioedema
Interactions with other patient drugs, OTC or herbal Lab value alterations caused by medicine
medicines (ask patient specifically) Monitor BUN, creatinine, and electrolyte levels periodically. Serum
Additive hypotension with other antihypertensive agents (Coreg potassium may be increased and BUN and creatinine transiently
for ex.) increased, whereas sodium levels may be decreased. If elevated BUN or
serum creatinine concentrations occur, dosage reduction or withdrawal
may be required. Monitor CBC periodically during therapy in patients
with collagen vascular disease and/or renal disease. May rarely cause
slight decrease in hemoglobin and hematocrit and agranulocytosis. May
cause elevated AST, ALT, alkaline phosphatase, and serum bilirubin.
Be sure to teach the patient the following about this
medication
Instruct patient to take exactly as directed at the same time each day,
even if feeling well. Missed doses should be taken as soon as possible
but not if almost time for next dose. Do not double doses. Warn patient
not to discontinue ACE inhibitor therapy unless directed by health care
professional. Caution patient to avoid salt substitutes containing
potassium or foods containing high levels of potassium or sodium unless
directed by health care professional. Caution patient to change positions
slowly to minimize hypotension, particularly after initial dose. Advise
patient to consult health care professional before taking any OTC
medications, especially cold remedies. May cause dizziness. Caution
patient to avoid driving and other activities requiring alertness until
response to medication is known. Instruct patient to notify health care
professional if rash; mouth sores; sore throat; fever; swelling of hands or
feet; irregular heart beat; chest pain; dry cough; hoarseness; swelling of
face, eyes, lips, or tongue; or if difficulty swallowing or breathing
occurs. Persistent dry cough may occur and may not subside until
medication is discontinued. Consult health care professional if cough
becomes bothersome. Also notify health care professional if nausea,
vomiting, or diarrhea occurs and continues. Encourage patient to comply
with additional interventions for hypertension (weight reduction, low
sodium diet, discontinuation of smoking, moderation of alcohol
consumption, regular exercise, and stress management).
Nursing Process- Assessment Assessment Evaluation
(Pre-administration assessment) Why would you hold or not give this Check after giving
Take blood pressure med? Decrease in blood pressure without
If bp is too low (systolic less than 100) appearance of side effects and
contact physician. These should not be improvement in survival and
stopped abruptly reduction of symptoms in heart
failure