Isosorbide Dinitiate

INDEX Generic Name isosorbide dinitrate Peak UNK

Trade Name

Onset 15-40 min

NURS 2236 Clinical Form 3: Clinical Medications Worksheet (You will need to made additional copies of these forms) Classification Dose Route Time/Frequency nitrate vasodilator Duration 4hr

Why is your patient taking this medication? anginal attacks

20mg

PO

BID

Normal Dosage range 2.5-30mg qid ac and hs For IV meds, compatability with IV drips and/or solutions

Mechanism of action and indications Relief of acute anginal attacks and for management of long-term angina pectoris

Nursing Implications (what to focus on) Contraindications/warnings/interactions Hypersensitivity; severe anemia; Head trauma; cerebral hemorrhage; hypotension; pregnancy or lactation

Produce vasodilation. Decrease left ventricular enddiastolic pressure and left ventricular end-diastolic volume (preload). Net effect is reduced mycardial oxygen consumption. Increase coronary blood flow by dilating coronary arteries and improving collateral flow to ischemic regions

Common side effects dizziness; headache; apprehension; weakness; hypotension; tachycardia; paradoxic bradycardia; syncope; abdominal pain; nausea; vomiting; flushing; pallor; prespiration rash

Interactions with other patient drugs, OTC, or herbal medicines (ask patient specifically) Alcohol; tafdalafil; vardenafil; antihypertensives; beta blockers; calcium channel blockers; phenothiazines; aspirin; dihydroergotamine.

Nursing Process - Assessment (Pre-administration assessment Blood pressure; heartrate (pulse) Assess location, duration, intensity, and precipitating factors of anginal pain;

Lab value alterations caused by medicine false decrease of serum cholesterol determinations. Excessive doses may increase methemoglobin concentrations. May cause increase urine vanillylmandelic acid (VMA) concentrations. Be sure to teach the patient the following about this medication Doses should be taken at least 2 hr apart; make position changes slowly to minimize orthostatic hypotension; may cause dizziness; avoid driving; no alcohol; headach is a common side effect and should decrease with continued use, take aspirin or acetaminophen; may experience dry mouth; blurred vision. Leave tabs in original container. Assessment Evaluation Why would you hold or not give Check after giving this med? lightheadedness; decreased blood pressure; Relief of anginal attacks and increase in cardiac output Increase in activity tolerance