单词 | eplerenone | ||||||||
释义 | eplerenonee·pler·e·noneE5188500 (əp-lĕr′ə-nōn′)eplerenoneeplerenonePharmacologic class: Aldosterone receptor blocker Therapeutic class: Antihypertensive Pregnancy risk category B ActionBinds to and blocks aldosterone receptors, disrupting normal sodium and water reabsorption and causing sodium and water excretion to increase. These actions reduce blood volume and blood pressure. AvailabilityTablets: 25 mg, 50 mg Indications and dosages➣ Hypertension Adults: 50 mg/day P.O. as a single dose. After 4-week trial, may increase to 50 mg P.O. b.i.d. if necessary. ➣ Heart failure; post-myocardial infarction (MI) Adults: Initially, 25 mg P.O. once daily. After 4 weeks, may increase to maximum dosage of 50 mg P.O. once daily. Contraindications• Hypersensitivity to drug • Hyperkalemia • Potassium supplements or potassium-sparing diuretics • Type 2 diabetes mellitus with microalbuminuria • Severe renal impairment PrecautionsUse cautiously in: • hepatic impairment • pregnant or breastfeeding patients • children (safety and efficacy not established). Administration• Give with or without food. • Know that drug may be given alone or with other antihypertensives. ![]() Adverse reactionsCNS: headache, dizziness, fatigue CV: angina, MI GI: diarrhea, abdominal pain GU: albuminuria, vaginal bleeding, changes in sexual function, gynecomastia and breast pain (in men) Metabolic: hypercholesterolemia, hyperkalemia Respiratory: cough Other: flulike symptoms InteractionsDrug-drug. Angiotensin-converting enzyme inhibitors, potassium-sparing diuretics, potassium supplements: increased risk of hyperkalemia CYP450-3A4 inhibitors: serious toxic effects Lithium: increased risk of toxicity Nonsteroidal antiinflammatory drugs: decreased hypertensive effect of eplerenone Patient monitoring• Monitor electrolyte levels, and watch for signs and symptoms of hyperkalemia. • Check vital signs, and ask patient about chest pain. • Monitor lipid panel. • Assess for new onset of persistent dry cough or flulike symptoms. Patient teachingSee Advise patient to immediately report chest pain, flulike symptoms, or persistent dry cough. • Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness. • Inform patient that drug may affect sexual function. Encourage him to discuss this issue with prescriber. • Advise female patient to discuss pregnancy or breastfeeding with prescriber before starting drug. • As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs mentioned above. eplerenone(e-ple-re-none) eplerenone,Inspra(trade name)ClassificationTherapeutic: antihypertensivesPharmacologic: aldosterone antagonists IndicationsActionTherapeutic effectsPharmacokineticsTime/action profile (antihypertensive effect)
Contraindications/PrecautionsAdverse Reactions/Side EffectsCentral nervous system
Gastrointestinal
Genitourinary
Endocrinologic
Fluid and Electrolyte
Metabolic
Miscellaneous
InteractionsDrug-Drug interactionConcurrent use of strong inhibitors of the CYP3A4 enzyme system (ketoconazole, itraconazole, nefazodone, clarithromycin, ritonavir, or nelfinavir ) significantly ↑ effects of eplerenone; concurrent use contraindicated. Concurrent use of weak inhibitors of the CYP3A4 enzyme system (erythromycin, saquinavir, fluconazole, verapamil ) may ↑ effects of eplerenone; initial dose of eplerenone should be ↓ by 50%.NSAIDs may ↓ antihypertensive effects.Concurrent use of ACE inhibitors or Angiotensin II receptor blockers may ↑ risk of hyperkalemia.Route/DosageHypertensionHF Post-MIAvailability (generic available)Nursing implicationsNursing assessment
Potential Nursing DiagnosesDecreased cardiac output (Indications)Noncompliance (Patient/Family Teaching) Implementation
Patient/Family Teaching
Evaluation/Desired Outcomes
eplerenone(əp-lĕr′ə-nōn′) |
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