Teveten

Teveten

eprosartan

(ep-roe-sar-tan) ,

Teveten

(trade name) Pregnancy Category: D

Indications

Action

Pharmacokinetics

Time/action profile (antihypertensive effect with chronic dosing)

ROUTE	ONSET	PEAK	DURATION
PO	within 1–2 hr	2–3 wksr	24 hr

Contraindications/Precautions

Adverse Reactions/Side Effects

Central nervous system

• depression
• fatigue

Cardiovascular

• hypotension

Ear, Eye, Nose, Throat

• pharyngitis
• rhinitis

Fluid and Electrolyte

• hyperkalemia

Gastrointestinal

• abdominal pain

Genitourinary

• impaired renal function

Musculoskeletal

• pain

Miscellaneous

• angioedema (life-threatening)

Interactions

Drug-Drug interaction

Additive hypotension with other antihypertensives.Excessive hypotension may occur with concurrent use of diuretics.↑ risk of hyperkalemia with concurrent use of potassium supplements,potassium-containing salt substitutes, or potassium-sparing diuretics.↑ risk of hyperkalemia, renal dysfunction, hypotension, and syncope with concurrent use of ACE inhibitors or aliskiren ; avoid concurrent use with aliskiren in patients with diabetes or CCr <60 mL/minNSAIDs and selective COX-2 inhibitors may blunt the antihypertensive effect and ↑ the risk of renal dysfunction.

Route/Dosage

Availability (generic available)

In combination with: hydrochlorothiazide (Teveten HCT; see combination drugs).

Nursing implications

Nursing assessment

• Assess BP (lying, sitting, standing) and pulse frequently during initial dosage adjustment and periodically throughout therapy. Notify health care professional of significant changes.
• Monitor frequency of prescription refills to determine compliance.
• Assess patients for signs of angioedema (dyspnea, facial swelling). May rarely cause angioedema.
• Lab Test Considerations: Monitor renal function. May cause increase in BUN and serum creatinine.
  • May cause hyperkalemia.
  • May cause elevated AST, ALT, and alkaline phosphatase.
  • May cause slight decrease in hemoglobin, neutropenia, or thrombocytopenia.

Potential Nursing Diagnoses

Risk for injury (Adverse Reactions)
Noncompliance (Patient/Family Teaching)

Implementation

• Volume depletion should be corrected, if possible, before initiation of therapy.
• Oral: May be administered without regard to meals.

Patient/Family Teaching

• Emphasize the importance of continuing to take as directed, even if feeling well. Take missed doses as soon as remembered if not almost time for next dose; do not double doses. Instruct patient to take medication at the same time each day. Warn patient not to discontinue therapy unless directed by health care professional.
• Caution patient to avoid salt substitutes containing potassium or foods containing high levels of potassium or sodium unless directed by health care professional. See.
• Encourage patient to comply with additional interventions for hypertension (weight reduction, low-sodium diet, discontinuation of smoking, moderation of alcohol consumption, regular exercise, stress management). Medication controls but does not cure hypertension.
• Instruct patient and family on proper technique for monitoring BP. Advise them to check BP at least weekly and to report significant changes.
• Caution patient to avoid sudden changes in position to decrease orthostatic hypotension. Use of alcohol, standing for long periods, exercising, and hot weather may increase orthostatic hypotension.
• May cause dizziness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known.
• Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications, especially cough, cold, or allergy remedies.
• Instruct patient to notify health care professional of medication regimen before treatment or surgery.
• Instruct patient to notify health care professional if swelling of face, eyes, lips, or tongue or if difficulty swallowing or breathing occur.
• Advise women of childbearing age to use contraception and notify health care professional if pregnancy is suspected or planned, or if breastfeeding. If pregnancy is detected, discontinue medication as soon as possible. Avoid breastfeeding.
• Emphasize the importance of follow-up exams to evaluate effectiveness of medication.

Evaluation/Desired Outcomes

• Decrease in BP without appearance of excessive side effects.