Captopril Nursing Responsibilities
Classification: Angiotensin Converting Enzyme (ACE) Inhibitor, Antihypertensive
- Management of congestive heart failure (CHF)
- Reduces the risk of death or development of CHF after myocardial infarction (MI)
- Slows the progression of left ventricular dysfunction into overt heart failure
- Used to decreased the progression of diabetic neuropathy
Mechanism of Action
- Captopril (Capoten) is an angiotension converting enzyme inhibitor. An Angiotensin-Converting Enzyme converts angiotensin I to angiotensin II. Angiotensin II is a potent endogenous vasoconstrictor substance.
- ACE inhibitors block the conversion of angiotensin I to the vasoconstrictor angiotensin II. It also inactivates the vasodilator bradykinin and other vasodilatory prostaglandins.
- ACE inhibitors also increase plasma rennin levels and reduce aldosterine levels. This is due to the suppression of the rennin-angiotensin-aldosterone system resulting in decreased serum concentrations of angiotensin I and aldosterone. The reduction of angiotensin I leads to decreased aldosterone secretion and as a result small increases in serum potassium may occur along with sodium and fluid loss.
- Cross sensitivity among Ace inhibitors
- Angioedema (hereditary or idiopathic)
Use cautiously in
- Renal impairment
- Hepatic impairment
- Elderly patients
- Concurrent diuretic therapy
- Surgery or anesthesia
- Dizziness or lightheadedness
- Weakness or excessive tiredness
- Tachycardia or fast heartbeat
- Taste disturbances: salty or metallic taste or decreased ability to taste
- Sore throat
- Mouth sores
- Unusual bruising
- Monitor blood pressure and pulse frequently during initial dose adjustment and periodically during therapy. (for patients treated with hypertension)
- For patients treated with CHF, monitor weight and assess patient routinely for resolution of fluid overload. Signs of fluid overload are: peripheral edema, rales or crackles, dyspnea, weight gain and jugular vein distention.
- The nurse should keep in mind that Captopril may cause false-positive result for urine acetone.
- The drug should be administered 1 hour before or 2 hours after meals. It may be crushed if the patient has difficulty swallowing.
- Keep this medication in the container it came in, tightly closed, and out of reach of children.
- Store it at room temperature and away from excess heat and moisture (not in the bathroom).
- Throw away any medication that is outdated or no longer needed.
- Inform the patient that Captopril tablets may have a slight sulfur odor (like rotten eggs).
- Instruct the patient to notify the physician immediately when the following manifestations are experienced:
- chest pain
- swelling of the face, eyes, lips, tongue, arms, or legs
- difficulty breathing or swallowing
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