Ranolazine PDF

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Ranolazine med card...

Description

Class: Antianginals Generic Drug Name: Ranolazine (Ranexa)

Method of Action (MOA): Does not decrease BP or heart rate; remainder of mechanism is not known. Indications/Uses and expected Therapeutic outcome - Chronic angina pectoris/ Decreased frequency of angina

Contraindications and Precautions- Hepatic impairment - Renal impairment - Hypersensitivity - OB: use only if benefit outweigh risk to fetus - Concurrent use of potent inhibitors of CYP3A - Pedi: safety not established - Concurrent use of inducers of CYP3A - Geri: ^ risk of adverse reaction in >75yr - Lactation Interaction: -

^ levels: Ketoconazole, itraconazole, clarithromycin, nefazodone, nelfinavir, ritonavir, indinavir, and saquinavir Decrease levels: Rifampin, rifabutin, rifapentin, phenobarbital, phenytoin, & carbamazepine ^ Levels (do not exceed ranolazine dose of 500 mg twice daily): Verapamil, diltiazem, aprepitant, erythromycin, & fluconazole ^ levels: Cyclosporine & paroxetine ^ levels of simvastatin St. Johns wort: decrease levels Grapefruit juice: ^ levels

Adverse reactions: CNS: dizziness, headache CV: TORSADES DE POINTES, palpitations, QTc prolongation. EENT: tinnitus. GI: abdominal pain, constipation, dry mouth, nausea, vomiting, GU: Acute renal failure. Nursing Actions Assessment – - Assess location, duration, intensity, and precipitating factors of anginal pain. - Monitor ECG at baseline and periodically during therapy to evaluate effects on QT interval. Care / Implementation – - Ranolazine should be used in combination with amlodipine, beta blockers, or nitrates. - Do not administer with grapefruit juice or grapefruit products PO: May be administered without regard to food. Tablets should be swallowed whole; do not break, crush, or chew. Education or teaching – - Take as directed. If a dose is missed, take the usual dose at the next scheduled time; do not double doses. Explain to patient that ranolazine is used for chronic therapy and will not help an acute angina episode - avoid grapefruit juice and grapefruit products

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May cause dizziness and light-headedness. Caution patient to avoid driving and other activities requiring alertness until response to medication is known. Notify HCP if fainting occurs Inform patient that ranolazine may cause changes in the ECG. Patient should inform HCP if they have a personal or family history of QTc prolongation, congenital long QT syndrome, or proarrhythmic conditions such as hypokalemia. Inform HCP if pregnancy is planned, or suspected, or if breast feeding

Evaluation - Evaluate for Decrease in frequency of angina attacks...