Ramipril 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.

Ramipril
Brand Name: Altace
Pregnancy Category C (first trimester), Pregnancy Category D
(second and third trimesters)
Drug classes: Antihypertensive, Angiotensin-converting enzyme (ACE)
inhibitor
Therapeutic actions
Ramipril blocks ACE from converting angiotensin I to angiotensin II, a
powerful vasoconstrictor, leading to decreased BP,
decreased aldosterone secretion, a small increase in serum potassium levels,
and sodium and fluid loss; increased prostaglandin synthesis also may be
involved in the antihypertensive action.
Indications
Treatment of hypertension alone or in combination with thiazide-type
diuretics
Treatment of CHF in stable patients in the first few days after MI
To decrease the risk of cardiovascular disease in patients at risk for
developing CAD
Contraindications
Contraindicated with allergy to ramipril, pregnancy (embryocidal in
preclinical studies).
Adverse effects

Tachycardia, angina pectoris, MI, Raynaud's syndrome, CHF, hypotension in

salt/volume depleted patients
Rash, pruritus, pemphigoid-like reaction, scalded mouth
sensation, exfoliative dermatitis, photosensitivity, alopecia
Gastric irritation, aphthous ulcers, peptic
ulcers, dysgeusia, cholestatic jaundice, hepatocellular injury, anorexia,
constipation
Proteinuria, renal insufficiency, renal failure, polyuria, oliguria, urinary
frequency
Neutropenia, agranulocytosis, thrombocytopenia, hemolytic
anemia, pancytopenia
Cough, malaise, dry mouth, lymphadenopathy, angioedema
Drug Interactions:
Exacerbation of cough if taken with capsaicin
Increased serum levels and increased toxicity with lithium; monitor
patient closely
Nursing considerations
Administer 1 hr before or 2 hr after meals.
Discontinue diuretic for 23 days before beginning therapy, if
possible, to avoid severe hypotensive effect.
Open capsules and sprinkle contents over a small amount of
applesauce or mix in applesauce or water if patient has difficulty
swallowing capsules. Mixture is stable for 24 hr at room temperature
and 48 hr if refrigerated.
Alert surgeon and mark chart that ramipril is being used;
the angiotensin II formation subsequent to compensatory renin release
during surgery will be blocked; hypotension may be reversed with
volume expansion.
Monitor patient closely for falling BP secondary to reduction in fluid
volume (excessive perspiration and dehydration, vomiting, diarrhea)
because excessive hypotension may occur.

 Reduce dosage in patients with impaired renal function.