Amlodipine Besylate; Norvasc

Amlodipine besylate

Brand Name: Norvasc

Pregnancy Category C

Drug classes: Calcium channel-blocker, Antianginal drug, Antihypertensive

 

Therapeutic actions

Inhibits the movement of calcium ions across the membranes of cardiac and arterial muscle cells; inhibits transmembrane calcium flow, which results in the depression of impulse formation in specialized cardiac pacemaker cells, slowing of the velocity of conduction of the cardiac impulse, depression of myocardial contractility, and dilation of coronary arteries and arterioles and peripheral arterioles; these effects lead to decreased cardiac work, decreased cardiac oxygen consumption, and in patients with vasospastic (Prinzmetal's) angina, increased delivery of oxygen to cardiac cells.

 

Indications

· Angina pectoris due to coronary artery spasm (Prinzmetal's variant angina)

· Chronic stable angina, alone or in combination with other agents

· Essential hypertension, alone or in combination with other antihypertensives

Contraindications

· Contraindicated with allergy to amlodipine, impaired hepatic or renal function, sick sinus syndrome, heart block (second or third degree), lactation.

 

Adverse effects

Dizziness, light-headedness, headache, asthenia, fatigue, lethargy, Peripheral edema, arrhythmias, Flushing, rash, Nausea, abdominal discomfort

 

Drug Interaction

· Possible increased serum levels and toxicity of cyclosporine if taken concurrently

 

Nursing considerations

· Monitor patient carefully (BP, cardiac rhythm, and output) while adjusting drug to therapeutic dose; use special caution if patient has CHF.

· Monitor BP very carefully if patient is also on nitrates.

· Monitor cardiac rhythm regularly during stabilization of dosage and periodically during long-term therapy.

· Administer drug without regard to meals.