Olmesartan medoxomil
Brand Name: Benicar
Pregnancy Category C (first trimester), Pregnancy Category D (second and third trimesters)
Drug classes: Angiotensin II receptor antagonist, 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 vasoconstricting effect of the renin–angiotensin system as well as the release of aldosterone leading to decreased blood pressure; may prevent the vessel remodeling associated with the development of atherosclerosis.
Indication
· Treatment of hypertension, alone or in combination with other antihypertensive agents
Contraindications
· Contraindicated with hypersensitivity to any component of the drug; pregnancy (use during the second or third trimester can cause injury or even death to the fetus), lactation.
Adverse effects
Headache, dizziness, syncope, muscle weakness, Hypotension, tachycardia, Rash, inflammation, urticaria, pruritus, alopecia, dry skin, Diarrhea, abdominal pain, nausea, constipation, dry mouth, dental pain, Increased CPK, hyperglycemia, hypertriglyceridemia, URI symptoms, bronchitis, cough, sinusitis, rhinitis, pharyngitis
Back pain, flulike symptoms, fatigue, hematuria, arthritis, angioedema
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 olmesartan; fetal injury and deaths have been reported.
· Find an alternate method of feeding the infant if given 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 olmesartan 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.
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