Minoxidil 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.

Minoxidil

Brand Name: Loniten, Minox (CAN)Rogaine, Rogaine Extra Strength

Pregnancy Category C

Drug classes: Antihypertensive,Vasodilator

Therapeutic actions

Acts directly on vascular smooth muscle to cause vasodilation, reducing elevated systolic and diastolic BP; does not interfere with CV reflexes; does not usually cause orthostatic hypotension but does cause reflex tachycardia and renin release, leading to sodium and water retention; mechanism in stimulating hair growth is not known, possibly related to arterial dilation.

Indications

· Severe hypertension that is symptomatic or associated with target organ damage and is not manageable with maximum therapeutic doses of a diuretic plus two other antihypertensive drugs; use in milder hypertension not recommended

· Alopecia areata and male pattern alopecia--topical use when compounded as a 1%–5% lotion or 1% ointment

Contraindications

· Contraindicated with hypersensitivity to minoxidil or any component of the topical preparation (topical); pheochromocytoma (may stimulate release of catecholamines from tumor); acute MI; dissecting aortic aneurysm; lactation.

Adverse effects

Fatigue, headache

Tachycardia (unless given with beta-adrenergic blocker or other sympatholytic drug), pericardial effusion and tamponade; changes in direction and magnitude of T-waves; cardiac necrotic lesions (reported in patients with known ischemic heart disease, but risk of minoxidil-associated cardiac damage cannot be excluded)

Temporary edema, hypertrichosis (elongation, thickening, and enhanced pigmentation of fine body hair occurring within 3–6 wk of starting therapy; usually first noticed on temples, between eyebrows and extending to other parts of face, back, arms, legs, scalp); rashes including bullous eruptions; Stevens-Johnson syndrome; darkening of the skin

Nausea, vomiting

Initial decrease in Hct, Hgb, RBC count

Irritant dermatitis, allergic contact dermatitis, eczema, pruritus, dry skin/scalp, flaking, alopecia (topical use)

Bronchitis, upper respiratory infection, sinusitis (topical use)

Drug Interactions:

· Risk of profound orthostatic hypotension if given with guanethidine. Stop guanethidine; if not possible, hospitalize patient

Nursing considerations

· Apply topical preparation to affected area; if fingers are used to facilitate drug application, wash hands thoroughly afterward.

· Do not apply other topical agents, including topical corticosteroids, retinoids, and petrolatum or agents known to enhance cutaneous drug absorption.

· Do not apply topical preparation to open lesions or breaks in the skin, which could increase risk of systemic absorption.

· Arrange to withdraw oral drug gradually, especially from children; rapid withdrawal may cause a sudden increase in BP (rebound hypertension has been reported in children, even with gradual withdrawal; use caution and monitor BP closely when withdrawing from children).

· Arrange for echocardiographic evaluation of possible pericardial effusion; more vigorous diuretic therapy, dialysis, other treatment (including minoxidil withdrawal) may be required.