Ivabradine PDF

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Ivabradine...

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Class: HCN channel blockers Generic name (trade name): Ivabradine (corlanor) MOA: blocks hyperpolarization-activated cyclic nucleotide-gated (HCN) channel in SA node, selectively inhibiting cardiac pacemaker current to decr. HR Indications: used to treat certain adults with heart failure (condition in which the heart is unable to pump enough blood to the other parts of the body) to decrease the risk that their condition will worsen and need to be treated in a hospital. Contradictions/precautions: hypersensitivity to drug or class, acute decompensated HF, clinically significant hypotension, sick sinus syndrome, SA block, 2nd-3rd degree AV block, bradycardia, pacemaker dependence, Interactions: Acetylsalicylic Acid (aspirin), Aspirin Low Strength (aspirin), Ativan (lorazepam), Benadryl (diphenhydramine), Cymbalta (duloxetine), Lasix (furosemide), Lyrica (pregabalin), Metoprolol Succinate ER (metoprolol), Metoprolol Tartrate (metoprolol), Paracetamol (acetaminophen), Plavix (clopidogrel), Singulair (montelukast), Valproate Sodium (valproic acid), Ventolin (albuterol), all may cause conduction disturbances, hypotension, HF, or renal or hepatic impairments. Desired outcome: reduced heart rate and fixing HF in patients with severe left ventricle blockage Common side effects: bradycardia, HTN, atrial fib., visual disturbance Adverse side effects: atrial fib., bradycardia, sinus arrest, heart block, hypersensitivity to drug, severe visual disturbance S/S Toxicity: severe bradycardia, dizziness, nausea, sinus arrest, and pale complexion. Overdose: Cases of ivabradine overdose can appear clinically similar to other cardiotoxins such as beta blocker or calcium channel blocker overdoses. No recommended standardized protocol is apparent Nursing process: Follow the nursing process, make sure a thorough assessment is done. Address any confusion on adverse effects and Drug use. Make sure route and dosage are correct. Look for adverse effects, any possible drug interactions, proper baseline (pulse, BP, and weight) and to minimize adverse effects while maximizing its therapeutic effect. Assessment: check BP, PR, peripheral pulse, capillary refill time, presence of edema, heart and breath sounds, weight, intake and output amounts, ECG, renal & liver function test, alcohol intake and smoking history as well as family history also check current and past drug history. Care/ implementation: monitor BP and vital signs. Generally titrated and shouldn’t be given with strong CYP3A4 inhibitors or grapefruit. Check dosage and prescription before administered. Monitor for adverse effects and desired outcomes. Education: inform patient to stay away from smoking alcohol and grapefruit because they all have negative effect on the drug. Instruct patients on how to take their radial pulse so they can be on top of their vital signs as well.

Evaluation: monitor for improvement in symptoms of HF, and improve cardiac function. Also, monitor for any adverse effects of this drug....