Medication niCARdipine

Name
Trade Name Cardene
Generic Name nicardipine (CCB)
Usual Dose IV: (Adults) Substitute for PO nicardipine if PO dose is 20 mg q 8 hr, then
infusion rate is 0.5 mg/hr; if PO dose is 30 mg q 8 hr, then infusion rate is 1.2
mg/hr; if PO dose is 40 mg q 8 hr, then infusion rate is 2.2 mg/hr. Patients
not receiving PO nicardipine initiate therapy at 5 mg/hr, may be increased
by 2.5 mg q 515 min as needed (up to 15 mg/hr).

Ordered Dose 20MG

Route & IV 20-150 ml per hr
Frequency
Action of Inhibits the transport of calcium into myocardial and vascular smooth muscle
Medication cells, resulting in inhibition of excitation-contraction coupling and
subsequent contraction.
Therapeutic Effect(s):
Systemic vasodilation resulting in decreased BP.
Coronary vasodilation resulting in decreased frequency and severity
of attacks of angina.

Side Effects CNS: abnormal dreams, anxiety, confusion, dizziness, drowsiness, headache,
jitteriness, nervousness, psychiatric disturbances, weakness
EENT: blurred vision, disturbed equilibrium, epistaxis, tinnitus
Resp: cough, dyspnea, shortness of breath
CV: ARRHYTHMIAS, HF, peripheral edema, bradycardia, chest pain,
hypotension, palpitations, syncope, tachycardia
GI: liver function tests, anorexia, constipation, diarrhea, dry mouth,
dysgeusia, dyspepsia, nausea, vomiting
GU: dysuria, nocturia, polyuria, sexual dysfunction, urinary frequency
Derm: dermatitis, erythema multiforme, flushing, sweating,
photosensitivity, pruritus/urticaria, rash
Endo: gynecomastia, hyperglycemia

Nursing Monitor BP and pulse prior to therapy, during dose titration, and
Considerations periodically throughout therapy. Monitor ECG periodically during
prolonged therapy.
o Monitor intake and output ratios and daily weight. Assess for
signs of HF (peripheral edema, rales/crackles, dyspnea, weight
gain, jugular venous distention).
 Assess for rash periodically during therapy. May cause Stevens-
Johnson syndrome. Discontinue therapy if severe or if accompanied
with fever, general malaise, fatigue, muscle or joint aches, blisters,
oral lesions, conjunctivitis, hepatitis, and/or eosinophilia.
Angina: Assess location, duration, intensity, and precipitating factors
of patient's anginal pain.
Lab Test Considerations: Total serum calcium concentrations are not
affected by calcium channel blockers.
Monitor serum potassium periodically. Hypokalemia risk of
arrhythmias; should be corrected.
Monitor renal and hepatic functions periodically during long-term
therapy. Several days of therapy may cause hepatic enzymes, which
return to normal upon discontinuation of therapy.
Continuous Infusion: Diluent: Dilute each 25-mg ampule with 240 mL of
D5W, D5/0.45% NaCl, D5/0.9% NaCl, 0.45% NaCl, or 0.9% NaCl. Infusion
is stable for 24 hr at room temperature. Concentration: 0.1 mg/mL.
Rate: Titrate rate according to BP response. Administer through large
peripheral veins or central veins to reduce risk of venous thrombosis,
phlebitis, local irritation, swelling, extravasation, and vascular impairment.
Change infusion site every 12 hours to minimize risk of peripheral venous
irritation.