sensitivity to ACE inhibitors, pregnancy (D), lactation, childrenPrecautions: Impaired liver function, hypovolemia, blood dyscrasias, CHF, COPD, asthma, elderlyPharmacokinetics:PO:Peak 3 hr; serum protein binding 97%; half-life 12 hr; metabolized by liver (metabolites excreted in urine, feces)Interactions/incompatibilities:•Increased hypotension: diuretics, other antihypertensives, ganglionic blockers, adrenergic blockers•Increased toxicity: vasodilators, hydralazine, prazosin, K-sparing diuretics, sympathomimetics•Decreased absorption: antacids•Decreased antihypertensive effect: indomethacin•Increased serum levels of: digoxin, lithium•Increased hypersensitivity: allopurinolLab test interferences:False positive: Urine acetoneNURSING CONSIDERATIONSAssess:•Blood studies: neutrophils, decreased platelets•B/P, orthostatic hypotension, syncope•Renal studies: protein, BUN, creatinine; watch for increased levels that may indicate nephrotic syndrome•Baselines in renal, liver function tests before therapy begins•K levels, although hyperkalemia rarely occurs•Dipstick of urine for protein qd in first morning specimen; if protein is increased, a 24-hr urinary protein should be collected•Edema in feet, legs daily•Allergic reactions: rash, fever, pruritus, urticaria; drug should be discontinued if antihistamines fail to help•Renal symptoms: polyuria, oliguria, frequency, dysuriaAdminister:•IV infusion of 0.9% NaCl (as ordered) to expand fluid volume if severe hypotension occursPerform/provide:•Storage in tight container at 86 F (30 C) or less•Supine or Trendelenburg position for severe hypotensionEvaluate:•Therapeutic response: decrease in B/PTeach patient/family:•Not to discontinue drug abruptly•Not to use OTC products (cough, cold, allergy) unless directed by physician; do not use salt substitutes containing potassium withou...
