hypertension, management of CHF
Block conversion of angiotensin I to angiotensin II, increases renin levels and
decreases aldosterone leading to vasodilation
• May cause hypersensitivity (allergic) reactions and angioedema (swelling of face, lips, tongue, throat)
• Can cause neutropenia – check WBCs regularly
• Use cautiously with potassium supplements and potassium sparing diuretics.
• Use cautiously with diuretic therapy
• Administer 1 hour before meals
• Monitor blood pressure often
• Monitor weight and fluid status
• Monitor renal profile
• Monitor CBC frequently
• Dry cough
Okay, let’s talk about Enalapril also known as Vasotec. This is an oral medication, as you can see here, but it also comes in an IV form. So remember when we talk about the therapeutic class versus the pharmacologic class, the therapeutic class is what the drug does in the body while the pharmacologic class is the chemical effect. So the therapeutic class of Enalapril is an anti-hypertensive while the pharmacologic class is an ACE inhibitor. Remember the little trick is the -pril at the end of a medication, which is characteristic of an ACE inhibitor. So we see this with Enalapril. Enalapril works by blocking the conversion of angiotensin I to angiotensin II. Renin levels are increased and Aldosterone decreases, which all leads to vasodilation. We use Enalapril for the treatment of hypertension and the management of congestive heart failure. ACE inhibitors like Enalapril come with some side effects. One that is common for ACE inhibitors is that dry cough, headache, loss of appetite, and dry mouth are also side effects that we see.
Let’s take a look at a few nursing considerations for enalapril. Be sure to monitor the patient’s CBC, renal profile, weight, and fluid status. While on Enalapril, use caution with patients who are on potassium supplements, potassium-sparing diuretics, or actually any type of diuretic therapy, because they can cause electrolyte abnormalities. And Enalapril may cause neutropenia, so white blood cells must be checked frequently. Be sure to teach the patient to take Enalapril one hour before eating. So, guys, the side effect of a dry cough is super annoying for ACE inhibitors. Most commonly will resolve in two to four weeks, but sometimes the patient isn’t able to make it that long. And in that case, they should be switched to an ARB. That’s it for Enalapril or Vasotec. Now go out and be your best self today and as always happy nursing.