DRUG NAME MECHANISM OF ACTION INDICATION / ADVERSE EFFECT NURSING RESPONSIBILITIES

CONTRAINDICATION

GENERIC: NIFEDIPINE Inhibits calcium ion influx across cell INDICATION: Body as a Whole/Systemic: chest pain, BEFORE:
BRAND: Adalat®¶, Adalat® CC, membrane during cardiac Adalat CC is indicated for the leg pain Dx:
Afeditab® CR depolarization, produces relaxation of treatment of hypertension. It may be Central Nervous System: paresthesia,  Check Doctors order
CLASS: Dihydropyridine Calcium coronary vascular smooth muscle and used alone or in combination with vertigo  Assess allergy for Nifedipine
Channel Blockers peripheral vascular smooth muscle, other antihypertensive agents. Dermatologic: rash  History: Allergy to nifedipine;
THERAPEUTIC: Calcium channel dilates coronary vascular arteries, Gastrointestinal: abdominal pain, pregnancy; lactation
blocker, Antihypertensive, Anti- increases myocardial oxygen delivery diarrhea, dry mouth, dysphagia, dyspepsia,  Assess cardiac status with BP, pulse,
anginal in patients with vasospastic angina. CONTRAINDICATION: eructation, esophagitis, flatulence, respiration and ECG.
PHARMACOLOGIC: Concomitant administration with gastrointestinal disorder, gastrointestinal  Monitor BP and pulse before therapy,
Cardiovascular agent; SOURCE: strong P450 inducers, such as hemorrhage, GGT increased, gum during dose titration and periodically
Calcium channel blocker PPD’s Better Pharmacy Drug hand rifampin, are contraindicated since disorder, gum hemorrhage, vomiting during the therapy.
Antiarrhythmic (Classiv) book 9th Edition 2009 the efficacy of nifedipine tablets Urogenital: impotence, urinary frequency 
No nitrate vasodilator could be significantly reduced. Musculoskeletal: arthralgia, arthritis, joint
DOSAGE: Nifedipine must not be used in cases disorder, myalgia, myasthenia, leg cramps Tx:
Adalat CC/Afeditab CR/Nifediac of cardiogenic shock. Respiratory: dyspnea, increased cough,
 Perform a thorough physical assessment
CC/Nifedical Adalat is contraindicated in patients rales, pharyngitis, stridor, epistaxis,
to establish baseline data before drug
XL/Nifedipine/Procardia XL Oral with a known hypersensitivity to any rhinitis
therapy begins, to determine the
Tab ER: 30mg, 60mg, 90mg component of the tablet. Special Senses: abnormal vision,
effectiveness of therapy, and to evaluate
Adalat/Nifedipine/Procardia Oral DRUG TO DRUG amblyopia, conjunctivitis, diplopia, eye
for the occurrence of any adverse effects
Cap: 10mg, 20mg INTERACTION: disorder, eye hemorrhage, tinnitus
associated with drug therapy.
ROUTE: ORAL q8 nifedipine is mainly eliminated by
 Periodically assess dose
metabolism and is a substrate of
 Administer the right dose at the right
CYP3A. Inhibitors and inducers of
time
CYP3A can impact the exposure to
nifedipine and consequently its  Measure and record weight to monitor
desirable and undesirable effects. In fluid changes
vitro and in vivo data indicate that EDx:
nifedipine can inhibit the metabolism  instruct patient on technique for
of drugs that are substrates of monitoring pulse. If heart rate is below
CYP3A, thereby increasing the 50 beats per minute, the physician
exposure to other drugs. Nifedipine is should be notified.
a vasodilator, and coadministration of  Instruct patient on importance of
other drugs affecting blood pressure maintaining good dental hygiene and
may result in pharmacodynamic seeing dentists frequently for teeth
interactions. cleaning to prevent tenderness, bleeding
DRUG TO FOOD and gingival hyperplasia (gum bleeding).
INTERACTION:  Educate the patient about the purpose
Do not eat grapefruit or drink and importance of the drug.
grapefruit juice if you’re taking  Educate client on drug therapy to
nifedipine. Doing so can increase the promote compliance.
level of the drug in your body and  Ensure the patient takes the medication
increase your risk of side effects. as prescribed.
Your doctor will likely tell you to DURING:
avoid grapefruit at least 3 days before Dx:
starting to take nifedipine  Monitor BP carefully during titration
period. Patient may become severely
hypotensive, especially if also taking
other drugs known to lower BP.
 Assess for anginal pain, including
location, intensity, duration, and
alleviating and aggravating factors.
 Monitor intake and output rations and
daily weight.
Tx:
 Assess for signs of CHF such as
peripheral edema, rales/crackles,
dyspnea, weight gain and jugular vein
distention
 Provide comfort measures
 Provide safety measures (e.g. adequate
lighting, raised side rails, etc.) to prevent
injuries.
Edx:
 advise patient to take medication exactly
as directed. Missed doses should be
taken as soon as remembered unless
almost time for next dose.
 Instruct the patient not to double doses
 Instruct the patient to contact the
physician immediately if the following
are experienced or observed:
 Irregular heartbeat
 Dyspnea
 Swelling of hands and feet
 Pronounced dizziness
 Nausea
 Constipation
 Hypotension
 Severe or persistent headache
AFTER:
Dx:
 Monitor potassium and liver function
tests throughout treatment with
nifedipine
  Assess knowledge/teach patient
appropriate use, interventions to reduce
side effects, and adverse symptoms to
report
 Monitor for effectiveness as exhibited by
a decrease in symptoms
 Monitor for side effects.
Tx:
 Provide safety measures (e.g. adequate
lighting, raised side rails, etc.) to prevent
injuries.
 Provide comfort measures (e.g. voiding
before dosing, taking food with drug,
etc.) to help patient tolerate drug effects
Edx:
 Instruct patient and family/caregivers to
report other troublesome side effects
such as severe or prolonged skin
problems (rash, hives) or GI problems
(nausea, vomiting, diarrhea, abdominal
pain).
 Monitor patient compliance to drug
therapy.
 Advise pt. to avoid alcohol intake.
 Instruct patient to verbalize feelings and
concerns.