Nifedipine Med card SIM PDF

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Summary

Pre assignment for Simulation Experience in OB...

Description

Generic name: Nifedipine

Drug class: Antihypertensive

Therapeutic action – how does it work?

Purposes – why is drug given?

Calcium channel blocker that suppresses contractions by inhibiting calcium from entering the cells.

To prolong a preterm labor situation

Contraindications/precautions – when would you NOT use?

Side effects – undesired effects?

Administration – how is it given? Route, dosage, special instructions: Capsule or tablet form PO, 10mg every 20 minutes for three doses total, followed by 20mg every 4-6 hours max dose of 160mg/day, DO NOT hang w/ mag sulfate or directly after beta 2 adrenergic agonist Complications – dangers of drug?

Orthostatic hypotension, anxiety, arrhythmias, gynecomastia, anorexia, dysuria, chest congestion

Arrhythmias, increased fall risk of patient due to orthostatic hypotension

Drug interactions – effects on other meds, other meds effects?

Nursing interventions – assessments, other actions?

Allergy to nifedipine or components, 2nd or 3rd degree AV block w/o artificial pacemaker,

Anesthetics: hypotension Antiviral drugs: increased risk of hypotension. Benazepril: increased HR and hypotensive effect. Beta-blockers: increased risk of profound hypotension, heart failure, and worsening of angina. Calcium supplements: interference w/ action of nifedipine. Carbamazepine, phenobarbital, phenytoin, rifabutin, rifampin, rifapentine, st. john’s wart, sympathomimetics, NSAIDs: decreased therapeutic effects of nifedipine Disopyramide, flecanide: increased risk of bradycardi, conduction defects, and heart failure Doxazocin: decreased doxazocin estrogens: increased fluid retention and decreased nifedipine effects lithium: increased risk of neurotoxicity Monitoring effectiveness – is it working? Contraction pain and intensity measured before and after to see how to titrate the medication to a therapeutic effect for the individual patient. Can measure contractions w/ external monitor, palpation, and intraurethral catheter (intraurethral catheter is best and most accurate way to gauge contraction intensity)

Don’t hang w/ mag sulfate or beta 2 adrenergic agonist, pts w/ glactose intolerance should. Not take nifedipine because it contains lactose, cautious in pts w/ cirrhosis because it is unknown how nifedipine affects this condition, must taper nifedipine therapy when starting and stopping drug has negative inotropic effect on some pts so close monitoring of HR and BP is indicated monitor I’s and O’s, make sure pt is not retaining fluid

Patient education – special advice? Swallow tablets whole do not chew or crush Do not take w/in 1 hour of high-fat meal or grapefruit, notify physician or nurse immediately if any chest pain, difficulty breathing, ringing in ears, and swollen gums. Minimize constipation by increasing fluid and fiber intake,...