Captopril
Trade name: Capotin, nhabace
Class:
antihypertensive, inhibitor of angiotensin synthesis. Pregnancy: (Category C)
Action:
• Captopril is a highly specific competitive inhibitor of
angiotensin I Converting enzyme.
• The enzyme is responsible for the conversion of angiotensin I to
angiotensin II which decrease BP.
• Reduce peripheral arterial resistance.
• Decrease aldosterone secretion which works to increase level of
serum potassium.
Uses:
• Hypertension.
• In combination with diuretics and digitalis in the treatment of
CHF.
Dose
hypertension, used alone, initially 12.5 mg twice
daily; if used in addition to
diuretic, or in elderly, initially 6.25 mg twice daily (first dose at bedtime);
usual maintenance dose 25 mg twice daily; max. 50 mg twice daily (rarely 3
times daily in severe hypertension)
Heart failure (adjunct), initially 6.25–12.5 mg under close
medical supervision;
usual maintenance dose 25 mg 2–3
times daily; usual max. 150
mg daily
Prophylaxis
after infarction in clinically stable patients with asymptomatic or
symptomatic left ventricular dysfunction, initially 6.25 mg, starting as early
as 3 days after infarction, then increased over several weeks to 150 mg daily (if tolerated) in divided
doses .
Contraindications:
• Hypersensitivity, Reno vascular disease and pregnancy.
Side effects:
• Skin
rash, loss of taste, neutropnea, nausea, vomiting,
• Hypotension, proteinuria, renal failure and hyperkalemia.
Nursing
considerations:
• In case of overdose, give normal saline to restore BP.
• Should not be discontinued without Dr. Instructions.
• Obtain baseline hematological studies, liver & renal
functions tests prior to beginning the treatment.
• Determine client understands of the therapy and if he/she takes
other medications.
Observe client closely for hypotension 3 hours after the initial dose.
• In case of hypotension, place client in supine position and give
IV saline infusion.
• Withhold potassium sparing diuretics and consult with physician
(hyperkalemia may occur).
• Take captopril 1 hour before meal or on an empty stomach.
• Report skin rash, heartburn, and chest pain to physician.
• Explain to client that he may develop loss of taste for 2-3
months, if it persists, notify the physician.
