Clinical Medications Worksheets Generic Name

Ramipril

Trade Name
Altace

Classification
antihypertensives

Dose
25mg

Route
po

Time/frequency
1000

Peak
3-6h

Onset
1-2h

Duration
24h

For IV meds, compatibility with IV drips and /or solutions Nursing Implications (what to focus on) Contraindications/warnings/interactions Hypersensitivity; History of angioedema with previous use of ACE inhibitors; OB: Potential for injury or death of fetus. If pregnancy occurs, discontinue immediately.; Lactation: Discontinue drug or use formula.Use Cautiously in:Black patients (monotherapy for hypertension less effective, may require additional therapy; higher risk of angioedema); Surgery/anesthesia (hypotension may be exaggerated); Women of childbearing potential; Renal impairment (especially renal artery stenosis), hypovolemia, hyponatremia, concurrent diuretic therapyinitial dose recommended; Pedi: Safety not established; Geri: Initial dose recommended.Exercise Extreme Caution in:Family history of angioedema.Adverse Reactions/Side Effectsdizziness, fatigue, headache, vertigo, weakness.cough.hypotension, chest pain.diarrhea, nausea, vomiting.impaired renal function.rashes.hyperkalemia.ANGIOEDEMA Common side effects cough hypotension dizziness fatigue hyperkalemia nausea/vomiting BUN, Cr elevated photosensitivity

Mechanism of action and indications (Why med ordered)

HTN

Angiotensin-converting enzyme (ACE) inhibitors block the conversion of angiotensin I to the vasoconstrictor angiotensin II. ACE inhibitors also prevent the degradation of bradykinin and other vasodilatory prostaglandins. ACE inhibitors also plasma renin levels and aldosterone levels. Net result is systemic vasodilation.

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically)
Excessive hypotension may occur with concurrent use of

hyperuricemia Lab value alterations caused by medicine

diuretics .Additive hypotension with other antihypertensive agents . risk of hyperkalemia with concurrent use of potassium supplements , potassium-sparing diuretics, potassium-containing salt substitutes , or angiotensin II receptor antagonists. NSAIDs and selective COX-2 inhibitors may blunt the antihypertensive effect and the risk of renal dysfunction levels and may the risk of lithium toxicity. risk of renal dysfunction when used with telmisartan ; concurrent use not recommended.

Be sure to teach the patient the following about this medication

Stop taking ramipril and call your doctor at once if you have a serious side effect such as: feeling like you might pass out; high potassium level (slow heart rate, weak pulse, muscle weakness, tingly feeling; dry mouth, thirst, confusion, swelling, and urinating less than usual or not at all; pale skin, dark colored urine, easy bruising or bleeding; jaundice (yellowing of the skin or eyes); or fever, chills, body aches, flu symptoms, sores in your mouth and throat.

Ramipril can be taken with or without food. Swallow the ramipril tablet whole. You may open the ramipril capsule and sprinkle the medicine into a half-cup (4 ounces) of water, apple juice, or applesauce to make swallowing easier. Swallow without chewing. You may store the mixture for up to 24 hours at room temperature, or up to 48 hours in a refrigerator. Conditions that may cause very low blood pressure include: vomiting, diarrhea, heavy sweating, dehydration, a low salt diet, or taking diuretics (water pills). Tell your doctor if you have a prolonged illness that causes diarrhea or vomiting. To be sure this medication is helping your condition, your blood pressure will need to be checked often. Your kidney or liver function may also need to be tested. Visit your doctor regularly.

Nursing Process- Assessment (Pre-administration assessment) BUN/Cr at baseline, then periodically, or more frequently if CHF, renal artery stenosis; electrolytes; BP; WBC if collagen vascular disease, especially if renal impairment

Assessment Why would you hold or not give this med?

Hypotensive Bradycardia

Evaluation
Lowering of BP in hypertensive patients. Decreased risk of myocardial infarction, stroke, or death from cardiovascular causes in high-risk patients. Increased survival and decreased heart failure progression after myocardial infarction.