AMLODIPINE and VERAMPIL

AMLODIPINE 

Mechanism of Action

Amlodipine binds to L-type calcium channels in the heart to stop calcium from flowing inward. This lessens the amount of intracellular calcium that is available, which

• Peripheral blood vessels' relaxation
• Antiarrhythmic and antianginal actions.
• Cardiac contractility is declining.
• Artery dilation in the heart.

Indication

• Hypertension
• Angina

Dose

• Adult
  • 10-20 mg od X po

Contraindication

• Impaired liver performance.
• Poor renal performance.
• illness-sinus syndrome
• Significant aortic stenosis.
• CHF
• Significant ventricular dysfunction
• Cardiomyopathy with hypertrophy.

Side Effect

• Borderline oedema
• Flushing
• Palpitation
• Syncope
• Headache
• Dizziness
• Somnolence
• Hypotension
• Bradycardia
• CCF
• Arrhythmia
• Fatigue
• The multiform erythema
• Angioedema
• Hyperglycemia
• Dyspepsia
• Dyspnoea
• Asthenia.
• Sexually inappropriate
• Gynecomastia,

Nursing Consideration

• Without respect to meals, the oral dose should be administered. Do not split or chew sustained-release pills.
• During the initial administration and titration of Diltiazem, careful blood pressure monitoring should be done. A physician should be informed if hypotension is evident.
• Keep an eye out for facial or peripheral edema; contact a doctor if it is severe.
• Monitor heart rate; palpitations that are dose-related may happen.
• Notify your doctor right away if you experience shortness of breath, palpitations, an irregular heartbeat, nausea, or constipation.
• Before each medication, check your pulse and let your doctor know if it's irregular or if your heart rate is below 50 beats per minute.
• Without first seeing a doctor, avoid breastfeeding while taking this medication.
• Until tolerance to low blood pressure is established, slowly transition from lying down to standing up to prevent falls caused by drug-related vertigo.

VERAMPIL

Mechanism of Action

• Verapamil prevents calcium from entering smooth muscle cells in the heart and blood vessels, which prevents excitation-contraction coupling and subsequent contraction.
• Prolongs the AV node refractory periods in cardiac conduction tissue and decreases SA and AV conduction.

Indication

• Angina
• Hypertension
• Tachyarrhythmias of the supraventricular aorta, IV.

Dose

• Adult
  • PO
    • tid: 80-160 mg; qid: 60-120 mg
  • IV
    • If necessary and the patient tolerated the initial dose, administer a second dose of 10 mg (0.15 mg/kg) by slow IV injection 15 to 30 minutes later.
• Child
  • PO
    • 3 divided doses of 4–8 mg/kg/day.

Contraindication

• Cardiovascular shock
• Pronounced bradycardia
• Very dysfunctional left ventricle.
• Ventricular hypertrophy.
• Heart failure that is uncompensated.
• Third- and second-degree heart blocks.
• Pronounced hypotension
• Long-term care for people with Wolf-Parkinson-White.
• Extreme CCF

Side Effect

• Hypotension
• Bradycardia
• Constipation
• Nausea and vertigo
• Headache
• Flushing
• Fatigue
• Seizures
• Hyperprolactinaemia
• Hepatotoxicity
• Respiratory oedema
• Borderline oedema
• AV block, MI
• Heart failure getting worse

Nursing Consideration

• While the medicine is being titrated to a therapeutic level, keep a close eye on your blood pressure, heart rhythm, and output.
• Make sure the patient consumes the SR tablets whole; they shouldn't be crushed, chewed, or chopped.
• To lessen Gl upset, administer SR form in the morning with breakfast.
• Patients with renal or hepatic impairment should be closely watched for potential medication buildup and negative effects.
• Before each medication, check your pulse and let your doctor know if it's irregular or if your heart rate is below 50 beats per minute.
• Driving and other potentially dangerous activities should be avoided until the drug response is known.
• Reduce your consumption of caffeine-containing beverages.
• Until tolerance to low blood pressure is developed, cautiously transition from laying down to standing up to minimize falls caused by drug-related dizziness.
• Report petechiae, easy bruising, and unexplained bleeding to your doctor.