NIFEDIPINEDRUG

NIFEDIPINE

1. B.Sahithya 2 nd year bsc (N) ACONC NIFEDIPINE

2. OBJECTIVES • Classification • Introduction • Doses • Available forms of drugs • Indications • Contra indications

3. CONT • Mechanism of action • Pharmacokinetics • Therapeutic effects • Adverse effects • Nurses responsibilities

4. CLASSIFICATION Nifedipine belongs to the class calcium channel blockers

5. INTRODUCTION Calcium channel blocker Prescribed to treat hypotension Affects the way calcium moves into the cells of the heart and blood vessels

6. CONT Results in the relaxation of blood vessels Increases the oxygen to the heart and reduce the work load of the heart

7. DOSAGES HYPERTENSION ADULT : 30 – 60 mg ,po,BD CHILD : 0.25 – 0.5 mg /kg /day ANGINA ADULT /CHILD : 10mg ,po,BD

8. AVAILABLE FORMS OF DRUG ROUTE : ORAL AVAILABLE FORMS TABLETS : 20mg ,30mg ,60 mg ,90 mg CAPSULES : 10mg , 20mg

9. TABLET

10. CAPSULE

11. INDICATIONS Hypertension Chronic stable angina

12. CONTRA INDICATIONS Acute MI Cardiogenic shock Acute unstable angina Severe GI narrowing

13. MECHANISM OF ACTION HYPER TENSION Highly specific to vascular smooth muscle Inhibits the calcium channel found on smooth muscle Increases the intracellular concentration of calcium

14. CONT Leads to smooth muscle cell relaxation Causes vasodilation Increased blood pressure

15. PHARMACOKINETICS ABSORPTION Nifedipine is almost completely absorbed from the gastrointestinal tract Oral bioavailability ranges from 45 to 68% because of first pass metabolism

16. CONT DISTRIBUTION The steady state volume of distrubtion of nifedipine is 0.062- 0.77L/kg Volume of distrubtion of the central compartment is 0.25 – 0.29L/kg

17. CONT METABOLISM It is metabolized in the liver by cypac Po: onset 20 min , duration 6 – 8 hrs EXCRETION 60-80 % excreted through the urine 20- 40 % excreted through the urine

18. THERAPEUTIC EFFECTS Maintains blood pressure Reduces angina Inbits calcium ion exchange across cell membrane Dilates coronary arteries Increases myocardial oxygen delivery

19. ADVERSE EFFECTS Dizziness Flushing Weakness Headache Joint pain Leg cramps

20. CONT Drowsiness Constipation Insomnia Rash Frequent urination Warm feeling of the skinn Peripheral edema Hypotension

21. NURSES RESPONSIBILITIES Monitor patient closely Monitor the patients BP and for any adverse reactions Vital signs should be monitored q 4 hours Educate patient on potential side effects /adverse reactions Encourage patient to avoid hazardous activities

22. CONT Allergy to nifedipine Preganancy Lactation Product drug from light and moisture Ensure that patients do not chew or divide sustained – release tablets

23. CONT Watch for symptoms for the heart failure Advise patient to avoid taking this drug with grape fruit juice PATIENT TEACHING Nifedipine can be taken with or without food Take the drug at the same time everyday If patient miss a dose of this medication take it as soon as possible

24. CONT Do not double the dose Limit caffine consumption Avoid alcohol