felodipine Nursing Considerations & Management

 Drug Name

Generic Name : felodipine

Brand Name: Plendil, Renedil (CAN)

Classification: Calcium channel-blocker, Antihypertensive

Pregnancy Category C

Dosage & Route
ADULTS
  • Initially, 5 mg PO daily; dosage may be gradually increased over 10–14 days. Usual dose is 2.5–10 mg PO daily. Doses greater than 10 mg PO daily are associated with an increased risk of peripheral edema.
PEDIATRIC PATIENTS
  • Safety and efficacy not established.
GERIATRIC PATIENTS OR PATIENTS WITH HEPATIC IMPAIRMENT
  • Monitor carefully; begin with 2.5 mg daily, and do not exceed 10 mg daily PO.
Therapeutic actions
  • Felodipine relaxes coronary vascular smooth muscles by inhibiting calcium ions from entering the ‘slow channels’ or voltage-sensitive areas of vascular smooth muscles and myocardium during depolarisation. It also increases myocardial O2 delivery in patients with vasospastic angina.
Indications
  • Essential hypertension, alone or in combination with other antihypertensives
Adverse effects
  • Flushing, headache, peripheral oedema, tachycardia, palpitation, dizziness, fatigue. Ankle swelling may occur. Hyperplasia, rash, pruritus. Gingival enlargement, angina, angioedema, decreased libido, insomnia, irritability in patients with pronounced gingivitis or periodontitis.
Contraindications
  • Hypersensitivity. Pregnancy.
Nursing considerations

CLINICAL ALERT! Name confusion has occurred between Plendil (felodipine) and Isordil (isosorbide); use caution.

Assessment
  • History: Allergy to felodipine, impaired hepatic function, sick sinus syndrome, heart block, lactation, pregnancy
  • Physical: Skin lesions, color, edema; P, BP, baseline ECG, peripheral perfusion, auscultation, R, adventitious sounds; liver evaluation, GI normal output; LFTs, urinalysis
Interventions
  • Have patient swallow tablet whole; do not chew or crush.
  • Monitor patient carefully (BP, cardiac rhythm and output) while drug is being adjusted to therapeutic dose.
  • Monitor cardiac rhythm regularly during stabilization of dosage and periodically during long-term therapy.
  • Administer drug without regard to meals.
Teaching points
  • Take this drug with meals if upset stomach occurs; swallow tablet whole, do not cut, crush, or chew. Do not drink grapefruit juice while using this drug.
  • You may experience these side effects: Nausea, vomiting (eat frequent small meals); headache (adjust lighting, noise, and temperature; medication may be ordered if severe).
  • Report irregular heart beat, shortness of breath, swelling of the hands or feet, pronounced dizziness, constipation.