Losartan Drug Study

In making a Drug Study, the following elements must be present: Generic Name and the Brand name (not all brands, just the brand used by the patient), Action, Indication, Pregnancy Category, Drug Classification, and Contraindication, Adverse Effect, Drug interaction and Nursing Consideration/Intervention…. Most clinical instructors preferred this to be in a long bond paper in printed or handwritten with paper in landscape.

Losartan potassium

Brand Name: Cozaar

Pregnancy Category C (first trimester), Pregnancy Category D (second and third trimesters)

Drug classes: Angiotensin II receptor blocker (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, alone or in combination with other antihypertensive agents

· Treatment of diabetic neuropathy with an elevated serum creatinine and proteinuria in patients with type 2 diabetes and a history of hypertension

Contraindications

· Contraindicated with hypersensitivity to losartan, pregnancy (use during the second or third trimester can cause injury or even death to the fetus), lactation.

Adverse effects

Headache, dizziness, syncope, insomnia, Hypotension, Rash, urticaria, pruritus, alopecia, dry skin, Diarrhea, abdominal pain, nausea, constipation, dry mouth, URI symptoms, cough, sinus disorders, Cancer in preclinical studies, back pain, fever, gout, muscle weakness

Drug Interactions:

· Decreased serum levels and effectiveness if taken concurrently with phenobarbital

· Losartan is converted to an active metabolite by cytochrome P450 3A4. Drugs that inhibit 3A4 (ketoconazole, fluconazole, diltiazem) may decrease the antihypertensive effects of losartan

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 losartan; fetal injury and deaths have been reported.

· Find an alternative method of feeding the baby 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 losartan 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.