Lippincotts Drugs to Know for the NCLEX

ramipril
ra-MI-pril
Altace
Pharmacologic class: ACE inhibitor
INDICATIONS
Hypertension
Heart failure after an MI
ACTION
Prevents conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. Less angiotensin II
decreases peripheral arterial resistance, decreasing aldosterone secretion, which reduces sodium and
water retention and lowers blood pressure.
ADVERSE REACTIONS
CV: hypotension, heart failure, MI, postural hypotension
GI: nausea, vomiting, diarrhea
Metabolic: hyperkalemia
Respiratory: dyspnea; dry, persistent, tickling, nonproductive cough
NURSING CONSIDERATIONS
If necessary, open capsule and sprinkle contents on a small amount of applesauce or mix with 4 oz
of water or apple juice. Give to patient immediately.
Monitor blood pressure regularly for drug effectiveness.
Monitor potassium level.
PATIENT TEACHING
Tell patient that if he has difficulty swallowing capsules, he can open drug and sprinkle contents on
a small amount of applesauce.
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.