| 释义 |
eprosartan
ep·ro·sar·tan E5190100 (ĕp′rō-sär′tăn)n. An angiotensin II receptor blocker drug, C23H24N2O4S, used in its mesylate form to treat hypertension.
[Perhaps E-, stereochemical pref. + pro(panoic acid) + -sartan, angiotensin II receptor blocker suff.; see losartan.]eprosartan
eprosartan [ep″ro-sar´tan] an angiotensin II" >angiotensin II antagonist that causes vasodilation and decreases the effects of aldosterone; used as an antihypertensive, administered orally.eprosartan (ep-roe-sar-tan) eprosartan, Teveten (trade name) Classification Therapeutic: antihypertensives
Pharmacologic: angiotensin ii receptor antagonists
Pregnancy Category: D
IndicationsAlone or with other agents in the management of hypertension.ActionBlocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II at various receptor sites, including vascular smooth muscle and the adrenal glands.Therapeutic effectsLowering of BP in patients with hypertension.PharmacokineticsAbsorption: 13% absorbed following oral administration.Distribution: Crosses the placenta.Protein Binding: 98%.Metabolism and Excretion: Excreted mostly unchanged in feces via biliary excretion.Half-life: 20 hr.Time/action profile (antihypertensive effect with chronic dosing)| ROUTE | ONSET | PEAK | DURATION |
|---|
| PO | within 1–2 hr | 2–3 wksr | 24 hr |
Contraindications/PrecautionsContraindicated in: Hypersensitivity; Concurrent use with aliskiren in patients with diabetes or moderate-to-severe renal impairment (CCr <60 mL/min) Obstetric: Can cause injury or death of fetus – if pregnancy occurs, discontinue immediately. Lactation: Discontinue drug or use formula.Use Cautiously in: Volume- or salt-depleted patients or patients receiving large doses of diuretics (correct deficits before initiating therapy); genetic implication Black patients (may not be as effective); Impaired renal function caused by primary renal disease or heart failure (may worsen renal function); Women of childbearing potential; Pediatric: Safety not established.Adverse Reactions/Side EffectsCentral nervous systemCardiovascularEar, Eye, Nose, ThroatFluid and ElectrolyteGastrointestinalGenitourinaryMusculoskeletalMiscellaneous- angioedema (life-threatening)
InteractionsDrug-Drug interactionAdditive hypotension with other antihypertensives.Excessive hypotension may occur with concurrent use of diuretics.↑ risk of hyperkalemia with concurrent use of potassium supplements,potassium-containing salt substitutes, or potassium-sparing diuretics.↑ risk of hyperkalemia, renal dysfunction, hypotension, and syncope with concurrent use of ACE inhibitors or aliskiren ; avoid concurrent use with aliskiren in patients with diabetes or CCr <60 mL/minNSAIDs and selective COX-2 inhibitors may blunt the antihypertensive effect and ↑ the risk of renal dysfunction.Route/DosageOral (Adults) 600 mg once daily when used as monotherapy in patients who are not volume depleted; may be ↑ to 800 mg/day (in 1–2 divided doses).Renal ImpairmentOral (Adults) CCr <60 mL/min—Do not exceed 600 mg/day.Availability (generic available)Tablets: 400 mg, 600 mg In combination with: hydrochlorothiazide (Teveten HCT; see combination drugs).Nursing implicationsNursing assessment- Assess BP (lying, sitting, standing) and pulse frequently during initial dosage adjustment and periodically throughout therapy. Notify health care professional of significant changes.
- Monitor frequency of prescription refills to determine compliance.
- Assess patients for signs of angioedema (dyspnea, facial swelling). May rarely cause angioedema.
- Lab Test Considerations: Monitor renal function. May cause increase in BUN and serum creatinine.
- May cause elevated AST, ALT, and alkaline phosphatase.
- May cause slight decrease in hemoglobin, neutropenia, or thrombocytopenia.
Potential Nursing DiagnosesRisk for injury (Adverse Reactions)
Noncompliance (Patient/Family Teaching)
Implementation- Volume depletion should be corrected, if possible, before initiation of therapy.
- Oral: May be administered without regard to meals.
Patient/Family Teaching- Emphasize the importance of continuing to take as directed, even if feeling well. Take missed doses as soon as remembered if not almost time for next dose; do not double doses. Instruct patient to take medication at the same time each day. Warn patient not to discontinue therapy unless directed by health care professional.
- Caution patient to avoid salt substitutes containing potassium or foods containing high levels of potassium or sodium unless directed by health care professional. See.
- Encourage patient to comply with additional interventions for hypertension (weight reduction, low-sodium diet, discontinuation of smoking, moderation of alcohol consumption, regular exercise, stress management). Medication controls but does not cure hypertension.
- Instruct patient and family on proper technique for monitoring BP. Advise them to check BP at least weekly and to report significant changes.
- Caution patient to avoid sudden changes in position to decrease orthostatic hypotension. Use of alcohol, standing for long periods, exercising, and hot weather may increase orthostatic hypotension.
- May cause dizziness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known.
- Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications, especially cough, cold, or allergy remedies.
- Instruct patient to notify health care professional of medication regimen before treatment or surgery.
- Instruct patient to notify health care professional if swelling of face, eyes, lips, or tongue or if difficulty swallowing or breathing occur.
- Advise women of childbearing age to use contraception and notify health care professional if pregnancy is suspected or planned, or if breastfeeding. If pregnancy is detected, discontinue medication as soon as possible. Avoid breastfeeding.
- Emphasize the importance of follow-up exams to evaluate effectiveness of medication.
Evaluation/Desired Outcomes- Decrease in BP without appearance of excessive side effects.
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