Date ordered: 07-05-10

Generic Name: Olmesartan

Brand Name: Benicar

Classification: Angiotensin II Receptor antagonist; Antihypertensive

Pregnancy Category: C (First Trimester); D (Second and Third Trimesters)

Indication: Treatment of hypertension alone or in combination with other anti-hypertensives

Ordered: 10 mg/tab 1tab OD in am 6am

Dosage: Hypertension

Adult: PO 20 mg q. d. may increase to 40 mg q.d. start with 5-10 mg q.d. if volume depleted

Mode of Action: Angiotensin II receptor (type AT1) antagonist acts as a potent vasodilator and primary vasoactive hormone of the rennin-angiotensin-aldosterone system. Selectively blocks the binding of angiotensin II to the AT1 receptors found in many tissues (e.g., vascular smooth muscle, adrenal glands). Antihypertensive effects results from blocking the vasoconstricting and aldosterone-secreting effects of angiotensin II. Antihypertensive effect is due to its potent vasodilation effect.

Drug-Drug Interaction: may increase hypotensive effect of the other antihypertensive; may cause hyperkalemia with potassium-sparing diuretics, potassium supplements; increase risk of lithium toxicity.

Herbal: ephedra, ma-huang may antagonize antihypertensive effects.

Contraindication: hypersensitivity to pimecrolimus or components of the cream; netherton’s syndrome; application to active cutaneous viral infection; pregnancy (category C first trimester, and category D in second and third trimester); lactation, children.

Use cautiously with renal impairment, hypovolemia and salt depletion

Side Effects:

CNS:headache, dizziness, syncope, muscle weakness

CV: hypotension, tachycardia

Dermatologic: rash, inflammation, urticaria, pruritus, alopecia, dry skin

GI: diarrhea, abdominal pain, nausea, constipation, dry mouth, dental pain

Hematologic: increased CPK, hyperglycemia, hypertriglyceridemia

Respiratory:URI symptoms, bronchitis, cough, sinusitis, rhinitis, pharyngitis

Other: back pain, flulike symptoms, fatigue, hematuria, arthritis, angioedema

Nursing Responsibilities:

a. Administer without regard to mealb. Monitor BP and CRc. Report dizziness, headache, nausea, vomiting, diarrhea, fever, chillsd. Place in supine position if serious hypotension occurse. Notify physician if hypotension or bradycardia occurs