AMLOSUN 5mg

Amlodipine
Class: Calcium channel blocker

Action: Inhibits movement of calcium ions across cell membrane in systemic and coronary vascular smooth muscle.

Indications: Hypertension; chronic stable angina; vasospastic (Prinzmetal’s or variant) angina.

Contraindications: Sick sinus syndrome; second- or third-degree atrioventricular (AV) block, except with a functioning pacemaker.

Route/Dosage:

• ADULTS: PO 5 to 10 mg qd. ELDERLY: PO Initially 2.5 mg QD
• HEPATIC IMPAIRMENT PO Initially 2.5 mg qd

Interactions:
Beta-blockers: May cause increased adverse cardiac effects as a result of myocardial depression.
Fentanyl: Severe hypotension or increased fluid volume requirements have occurred with similar drug.

Lab Test Interferences well documented.

Adverse Reactions

CV: Palpitations; peripheral edema; syncope; tachycardia; bradycardia; arrhythmias; ventricular asystoles.
CNS: Headache; dizziness; lightheadedness; fatigue; lethargy; somnolence.
DERM: Dermatitis; rash; pruritus; urticaria.
GI: Nausea; abdominal discomfort; cramps; dyspepsia.
RESP: Shortness of breath; dyspnea; wheezing.
OTHER: Flushing; sexual difficulties; muscle cramps, pain or inflammation.

Precautions

• Pregnancy: Category C.
• Lactation: Undetermined.
• Children: Safety and efficacy not established.
• CHF: Cautious use is required with this condition.
• Hepatic impairment: Cautious use is required.
• PATIENT CARE CONSIDERATIONS

Administration/Storage

Administer medication in morning.

• If patient has difficulty swallowing, crush tablets.
• Store in tightly closed container in cool location.

Assessment/Interventions

Obtain patient history, including drug history and any known allergies. Note any diabetes, liver disease, cardiac disease or sensitivity to calcium channel blockers.
Monitor BP and pulse before administration.

• Review baseline ECG.
  Assess for signs of withdrawal syndrome. Abrupt withdrawal may cause increased frequency and duration of angina. Gradual tapering of dose is necessary.
• Assess patient for signs of CHF during therapy.
• If chest pain occurs, assess for location, intensity, duration, and radiation. Nitroglycerin preparations may be administered in conjunction with this medication.
• If drug is used with other calcium channel blockers or beta-blockers, observe for intensification of side effects.
• Withhold medication and notify physician if any of the following signs and symptoms occur: Sudden severe dyspnea; edema of hands and feet; changes in ECG (widened QRS, prolonged QT segments); pulse falls below 50 bpm.
• If the patient experiences chest pain not relieved by medication, continue medication and notify physician.

OVERDOSAGE: SIGNS & SYMPTOMS

Nausea, weakness, dizziness, drowsiness, confusion, slurred speech, hypotension, bradycardia, second- or third-degree AV block

Patient/Family Education

• Teach patient how to monitor pulse before taking medication. Tell patient not to take medication if pulse if < 50 bpm and to call physician.
• Explain to patient how to monitor BP daily.
• Instruct patient not to stop taking this medication suddenly because doing so can cause chest pain and MI.
• Teach patient importance of good oral hygiene and frequent visits to dentist while taking medication.
• Inform patient that frequent follow-up appointments with physician are important to adjust medication dosage.
• Caution patient to avoid sudden position changes to prevent orthostatic hypotension.
• Instruct patient to avoid intake of alcoholic beverages or other CNS depressants.
• Advise patient that drug may cause drowsiness, and to use caution while driving or performing other tasks requiring mental alertness.
• Instruct patient not to take otc medications without consulting physician.