Norvasc (amlodipine)

NURS 1566 Clinical Form 3: Clinical Medications Worksheets (You will need to make additional copies of these forms) Generic Name amlodipine

Trade Name Norvasc

Classification Dose Route Time/frequency Antihypertensive, 5 mg PO Q am calcium channel blocker Duration Normal dosage range 24 hrs Initiate therapy at 2.5 mg/day, increase as required/tolerated (up to 10 mg/day).

Peak 6-9 hrs

Onset Unknown

Why is your patient getting this medication HTN Mechanism of action and indications (Why med ordered) Inhibits the transport of calcium into myocardial and vascular smooth muscle cells, resulting in inhibition of excitation-contraction coupling and subsequent contraction. Systemic vasodilation resulting in decreased blood pressure. Coronary vasodilation resulting in decreased frequency and severity of attacks of angina.

For IV meds, compatibility with IV drips and/or solutions N/A Nursing Implications (what to focus on) Contraindications/warnings/interactions Hypersensitivity, blood pressure < 90 mm Hg. Use cautiously in: Severe hepatic impairment (dosage reduction recommended), geriatric patients (dosage reduction recommended; increased risk of hypotension), aortic stenosis, history of CHF. Common side effects Headache, peripheral edema.

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically) Additive hypotension may occur when used concurrently with other antihypertensives (Prinivil, Coreg) or acute ingestion of alcohol.

Nursing Process- Assessment (Pre-administration assessment) Monitor blood pressure and pulse before therapy, during dose titration, and periodically during therapy. Monitor ECG periodically during prolonged therapy. Monitor intake and output ratios and daily weight. Assess for signs of CHF (peripheral edema, rales/crackles,

Lab value alterations caused by medicine Total serum calcium concentrations are not affected by calcium channel blockers. Be sure to teach the patient the following about this medication Advise patient to take medication as directed, even if feeling well. Take missed doses as soon as possible unless almost time for next dose; do not double doses. May need to be discontinued gradually. Instruct patient on correct technique for monitoring pulse. Instruct patient to contact health care professional if heart rate is <50 bpm. Caution patient to change positions slowly to minimize orthostatic hypotension. May cause drowsiness or dizziness. Advise patient to avoid driving or other activities requiring alertness until response to the medication is known. Instruct patient on importance of maintaining good dental hygiene and seeing dentist frequently for teeth cleaning to prevent tenderness, bleeding, and gingival hyperplasia (gum enlargement). Instruct patient to avoid concurrent use of alcohol or OTC medications, especially cold preparations, without consulting health care professional. Advise patient to notify health care professional if irregular heartbeats, dyspnea, swelling of hands and feet, pronounced dizziness, nausea, constipation, or hypotension occurs or if headache is severe or persistent. Caution patient to wear protective clothing and use sunscreen to prevent photosensitivity reactions. Advise patient to inform health care professional of medication regimen before treatment or surgery. Encourage patient to comply with other interventions for hypertension (weight reduction, low-sodium diet, smoking cessation, moderation of alcohol consumption, regular exercise, and stress management). Medication controls but does not cure hypertension. Instruct patient and family in proper technique for monitoring blood pressure. Advise patient to take blood pressure weekly and to report significant changes to health care professional. Assessment Evaluation Why would you hold or not give this Check after giving med? Decrease in blood pressure. Blood pressure < 90 mm Hg or heart rate < 50 bpm.

dyspnea, weight gain, jugular venous distention).