Nifedipine (Adalat,Procardia,others) Prototype Drug / .Therapeutic Class: Drug for hypertension and angina
Pharmacologic Class: Calcium channel blocker. ACTIONS AND USESNifedipine is CCB generally prescribed for HTN and variant or vasospastic angina. It is occasionally used to treat Raynaud's phenomenon and hypertrophic cardiomyopathy. Nifedipine acts by selectively bloking calcium channels in myocardial and vascular smooth muscle, including those in the coronary arteries. This results in less oxygen utilization by the heart, an increase in cardiac output, and a fall in blood pressure. It is available as extended-release tablets (XL). ADMINISTRATION ALERTS Do not administer immediate-release formulations of nifedipine if an
| Minimizing adverse effects:Continue to monitor vital signs. Take blood pressure lying, sitting, and standing to detect orthostatic hypotension. Be cautious with the elderly whe are at increased risk for hypotension. (CCBs cause vasodilation, resulting in lowered blood pressure. Orthostatic hypotension may increase the risk of falls and injury.) | Instruct the patient on the need to return periodically for lab work or ECGs.Advise the patient to carry a wallet identification card or wear medical identification jewelry indicating CCB therapy. | Continue to monitor periodic electrolyte levels, especially potassium, ECG as appropriate, and hepatic and renal function labs (Hypokalemia may increase the risk of dysrhythmias.) | Instruct the patient to call for assistance prior to getting out of bad or attempting to walk alone, and to avoid driving or other activities requiring mental alertness or physical coordination until the effects of the drug are known. | Ensure patient safety, especially in the elderly. Observe for dizziness. Monitor ambulation until the effects of the drug are known. (Dizziness from orthostatic hypotension may occur.) | Have the patient weigh self daily, ideally at the same time of day, and record weight