Lippincotts Drugs to Know for the NCLEX

enalapril maleate
eh-NAH-leh-prel
Vasotec
Pharmacologic class: ACE inhibitor
INDICATIONS
Hypertension
Symptomatic heart failure
Asymptomatic left ventricular dysfunction
ACTION
May inhibit ACE, preventing conversion of angiotensin I to angiotensin II, a potent vasoconstrictor.
Less angiotensin II decreases peripheral arterial resistance, decreasing aldosterone secretion,
reducing sodium and water retention, and lowering blood pressure.
ADVERSE REACTIONS
CNS: asthenia, headache, dizziness, fatigue, vertigo, syncope
CV: hypotension, chest pain
GU: decreased renal function (in patients with bilateral renal artery stenosis or heart failure)
Respiratory: dry, persistent, tickling, nonproductive cough, dyspnea Other: angioedema
NURSING CONSIDERATIONS
Closely monitor blood pressure response to drug.
Monitor potassium intake and potassium level.
Don’t confuse enalapril with Anafranil or Eldepryl.
PATIENT TEACHING
Instruct patient to avoid salt substitutes containing potassium. May cause hyperkalemia.
Inform patient that light-headedness can occur. Tell him to rise slowly to minimize this effect.
Tell patient to use caution in hot weather and during exercise. Lack of fluids, vomiting, diarrhea, and
excessive perspiration can lead to light-headedness and syncope.
Advise patient to report signs and symptoms of infection, such as fever and sore throat.