Captopril

Brand:
Acenorm; Capoten; Enzace; Novo-Captopril

AVAILABLE FORMS:
Tablets: 12.5mg; 25mg; 50mg; 100mg

INDICATIONS:

• Hypertension
• Heart failure
• Diabetic neuropathy

MECHANISM OF ACTION:
Captopril is in a group of drugs called ACE inhibitors. ACE stands for angiotensin converting enzyme. Thought to inhibit ACE, preventing conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. Reduced formation of angiotensin II decreases peipheral arterial resistance, decreasing aldosterone secretion, which reduces sodium and water retension and lowers blood pressure.

ADVERSE REACTION:
CNS: dizziness, fainting, headache, malaise, fatigue
CV: tachycardia, hypotension, angina pectoris
GI: abdominal pain, anorexia, constipation, diarrhea, dry mouth, dysgeusia, nausea, vomiting
Metabolic: hyperkalemia
Hematologic: leukopenia, anemia, pancytopenia
Respiratory: dyspnea, dry, persistent, nonproductive cough
Skin: urticarial rash, alopecia, pruritus

CONTRAINDICATIONS:
ACE inhibitors, including captopril, can be harmful to the fetus and should not be taken by pregnant women. Captopril is secreted in breast milk. Therefore it should be avoided by nursing mothers.

NURSING RESPONSIBILITY:

1. Take captopril exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.
2. Take each dose with a full glass of water.
3. Instruct patient to take drug 1 hour before meals; food in the GI tract may reduce absorbtion.
4. Vomiting, diarrhea, or heavy sweating can cause you to become dehydrated. This can lead to very low blood pressure, electrolyte disorders, or kidney failure while you are taking captopril. Drink plenty of water each day while you are taking this medication.
5. Captopril should be stored at room temperature, 15 to 30 C (59 to 86 F) and away from moisture.
6. Use cautiously in patients with renal impaired.
7. Monitor patient's blood pressure and pulse rate frequently.
8. Assists patients for sign of edema.
9. Instruct patient to report signs and symptoms of infection, such as fever and sore throat.

Metoprolol Tartrate; Succinate

Metoprolol (Lopressor, Metoprolol Succinate ER, Toprol-XL, betaloc)


AVAILABLE FORMS:
Metoprolol Succinate
Tablets: (extended release) 25mg; 50mg; 100mg; 200mg
Metoprolol Tartrate
Injection: img/ml in 5ml ampules
Tablets: 50mg; 100mg; 200mg



INDICATIONS:

• Hypertension
• Angina Pectoris

MECHANISM OF ACTION:
Metoprolol is in a group of drugs called beta-blockers. Beta-blockers affect the heart and circulation (blood flow through arteries and veins). A selective beta blocker that selectively blocks beta-adrenergenic receptor.



ADVERSE REACTIONS:
CNS: Fatigue; dizziness, depression; anxiety, nervousness
CV: slow or uneven heartbeats; hypotension; heart failure
GI: vomiting; diarrhea
Respiratory: Dyspnea; feeling short of breath, even with mild exertion
Skin: rash
Others: decreased sex drive, impotence, or difficulty having an orgasm



EFFECTS ON LAB TEST RESULTS:
May increase transaminase, alkaline phosphatase, LDH, and uric acid level.



CONTRAINDICATIONS:
FDA pregnancy category C. This medication may be harmful to an unborn baby. It is contraindicated also to breast-feeding mothers. Do not use this medication if you are allergic to metoprolol. Avoid using metoprolol if you have a heart problem such as heart block, sick sinus syndrome, or slow heart rate; and problems with circulation (such as Raynaud's syndrome). pheochromocytoma; or


NURSING CONSIDERATIONS:

1. Metoprolol can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
2. Avoid drinking alcohol, which could increase drowsiness and dizziness while you are taking metoprolol.
3. Store metoprolol at room temperature away from moisture and heat.
4. Hypertension often has no symptoms, so you may not even feel that you have high blood pressure. Continue using this medicine as directed, even if you feel well. You may need to use blood pressure medication for the rest of your life.
5. Metoprolol should be taken with food or just after a meal.Take this medication with a full glass of water.
6. Metoprolol can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.