NIFEDIPINE

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(nye-fed’i-peen)
Adalat, Adalat CC, Procardia, Procardia XL
Classifications: cardiovascular agent; calcium channel blocker; antiarrhythmic (class iv); nonnitrate vasodilator
Pregnancy Category: C

NURSING IMPLICATIONS

Assessment & Drug Effects

• Monitor BP carefully during titration period. Patient may become severely hypotensive, especially if also taking other drugs known to lower BP. Withhold drug and notify physician if systolic BP <90.
• Monitor blood sugar in diabetic patients. Nifedipine has diabetogenic properties.
• Monitor for gingival hyperplasia and report promptly. This is a rare but serious adverse effect (similar to phenytoin-induced hyperplasia).

Patient & Family Education

• Keep a record of nitroglycerin use and promptly report any changes in previous pattern. Occasionally, people develop increased frequency, duration, and severity of angina when they start treatment with this drug or when dosage is increased.
• Be aware that withdrawal symptoms may occur with abrupt discontinuation of the drug (chest pain, increase in anginal episodes, MI, dysrhythmias).
• Inspect gums visually every day. Changes in gingivae may be gradual, and bleeding may be exhibited only with probing.
• Seek prompt treatment for symptoms of gingival hyperplasia (easy bleeding of gingivae and gradual enlarging of gingival mass, especially on buccal side of lower anterior teeth). Drug will be discontinued if gingival hyperplasia occurs.
• Research shows that smoking decreases the efficacy of nifedipine and has direct and adverse effects on the heart in the patient on nifedipine treatment.
• Do not breast feed while taking this drug without consulting physician.

 

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