Drug Name Dosage & Route Action Indication Adverse Effects Contraindication Nursing Responsibility

Lowers blood pressure by

CAPTOPRIL Hypertension Hypertension; in conjunction Angioedema, hypersensitivity
specific inhibition of the Body as a Whole: Assessment & Drug Effects
(kap'toe-pril) Adult: PO 6.25–25 mg with digitalis and diuretics in to captopril or ACE
angiotensin-converting Hypersensitivity reactions,
t.i.d., may increase to CHF, diabetic nephropathy. inhibitors; hypotension;
enzyme (ACE). This serum sickness-like reaction,
50 mg t.i.d. (max: 450 pregnancy (category D), • Monitor BP closely
Capoten interrupts conversion arthralgia, skin eruptions. CV:
mg/d) lactation. following the first dose. A
sequences initiated by renin Slight increase in heart rate,
Child: PO 0.3–12.5 sudden exaggerated
Classifications: that lead to formation of first dose hypotension,
mg/kg q12–24h, may hypotensive response may
cardiovascular agent; angiotensin II, a potent dizziness, fainting. GI:
titrate up to max of 6 occur within 1–3 h of first
angiotensin-converting endogenous vasoconstrictor. Altered taste sensation (loss
mg/kg/d in 2–4 dose, especially in those
enzyme (ace) inhibitor; ACE inhibition alters of taste perception, persistent
divided doses with high BP or on a diuretic
antihypertensive agent hemodynamics without salt or metallic taste); weight
Infant: PO 0.15–0.3 and restricted salt intake.
compensatory reflex loss, intestinal angioedema.
mg/kg, may titrate up
to 6 mg/kg/d in 1–4
tachycardia or changes in Hematologic: Hyperkalemia, • Advise bed rest and BP
cardiac output (except in neutropenia, agranulocytosis monitoring for the first 3 h
divided doses
patients with CHF). (rare). Respiratory: cough. after the initial dose.
Neonate: PO 0.05–0.1
Peripheral vascular resistance Skin: Maculopapular rash,
mg/kg q8–24 h, may
is lowered by vasodilation. urticaria, pruritus,
• Monitor therapeutic
titrate up to 0.5 mg/kg effectiveness. At least 2 wk
Inhibition of ACE also leads angioedema, photosensitivity.
q6–24 h of therapy may be required
to decreased circulating Urogenital: Azotemia,
Premature infant: PO before full therapeutic
aldosterone. Reduced impaired renal function,
0.01 mg/kg q8–12h effects are achieved.
circulating aldosterone is nephrotic syndrome,
associated with a potassium- membranous • Lab tests: Establish baseline
Congestive Heart urinary protein levels before
sparing effect. In heart glomerulonephritis. Other:
Failure initiation of therapy and
failure, captopril Positive antinuclear antibody
Adult: PO 6.25–12.5 check at monthly intervals
administration is followed by (ANA) titers.
mg t.i.d., may increase for the first 8 mo of
a fall in CVP and pulmonary
to 50 mg t.i.d. (max: treatment and then
wedge pressure; hypotensive
450 mg/d) periodically thereafter.
action appears to be unrelated
to plasma renin levels. Perform WBC and
differential counts before
therapy is begun and at
approximately 2-wk
intervals for the first 3 mo of
therapy and then
periodically thereafter.