Irbesartan
Irbesartan
Brand Name: Avapro
Pregnancy Category C (first trimester), Pregnancy Category D (second and third trimesters)
Drug classes: Angiotensin II receptor antagonist (ARB), Antihypertensive
Therapeutic actions
Selectively blocks the binding of angiotensin II to specific tissue receptors found in the vascular smooth muscle and adrenal gland; this action blocks the vasoconstriction effect of the renin-angiotensin system as well as the release of aldosterone, leading to decreased blood pressure.
Indications
· Treatment of hypertension as monotherapy or in combination with other antihypertensives
· Slowing of the progression of kidney disease in patients with hypertension and type 2 diabetes
Contraindications
· Contraindicated with hypersensitivity to irbesartan, pregnancy (use during the second or third trimester can cause injury or even death to the fetus), lactation.
· Use cautiously with hepatic or renal dysfunction, hypovolemia.
Adverse effects
Headache, dizziness, syncope, muscle weakness
Hypotension, orthostatic hypotension
Rash, inflammation, urticaria, pruritus, alopecia, dry skin
Diarrhea, abdominal pain, nausea, constipation, dry mouth, dental pain
URI symptoms, cough, sinus disorders
Cancer in preclinical studies, back pain, fever, gout, fatigue
Nursing considerations
· Administer without regard to meals.
· Ensure that patient is not pregnant before beginning therapy; suggest the use of barrier birth control while using irbesartan; fetal injury and deaths have been reported.
· Find an alternative method of feeding the baby if giving drug to a nursing mother. Depression of the renin-angiotensin system in infants is potentially very dangerous.
· Alert surgeon and mark patient's chart with notice that irbesartan is being taken. The blockage of the renin-angiotensin system following surgery can produce problems. Hypotension may be reversed with volume expansion.
· Monitor patient closely in any situation that may lead to a decrease in blood pressure secondary to reduction in fluid volume (excessive perspiration, dehydration, vomiting, diarrhea); excessive hypotension can occur.