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Drug Name benazepril hydrochloride (ben a' za pril) Lotensin Pregnancy Category C (first trimester) Pregnancy Category D (second and third trimesters) Drug classes Antihyperten sive ACE inhibitor Oral

Dosages

Hypertension Adult: Initially, 10 mg once daily. Maintenance: 20-40 mg daily as a single or in 2 divided doses. Max dose: 80 mg/day. Child: 6 yr: 0.2 mg/kg/day. Max dose: 40 mg/day. Renal impairment: Avoid usage in children with CrCl <30 ml/min. CrCl Dosage (ml/min Recommendation ) <30 Initial dose: 5 mg daily. Max maintenance dose: 40 mg daily.

Therapeutic Actions Benazepril and its metabolite benazeprilat inhibit ACE that catalyzes the conversion of angiotensin I to angiotensin II, thus leading to reduced aldosterone secretion by the adrenal cortex and decreased vasopressor activity.

Indications Treatment of hypertension alone or in combination with thiazidetype diuretics

Heart failure Adult: Initially, 2.5 mg once daily adjusted according to patient's response. Max: 20 mg daily.

Adverse effects Headache, dizziness, fatigue; cough; somnolence, nausea; hypotension, transient elevations in BUN and serum creatinine; palpitations; constipation, gastritis; melena, rash, pruritus; musculoskel etal pain; paraesthesia , anxiety; UTI; hyperkalaem ia; leucopenia and flushing. Potentially Fatal: Angioedema (rare).

Contraindicatio ns Hypersensitivity . History of bilateral renal artery stenosis, angioedema; pregnancy.

Nursing considerations Assessment History: Allergy to benazepril or other ACE inhibitors, impaired renal function, CHF, salt or volume depletion, lactation, pregnancy Physical: Skin color, lesions, turgor; T; P, BP, peripheral perfusion; mucous membranes, bowel sounds, liver evaluation; urinalysis, LFTs, renal function tests, CBC and differential Interventions WARNING: Alert surgeon: Note use of benazepril on patient's chart; the angiotensin II formation subsequent to compensatory renin release during surgery will be blocked; hypotension may be reversed with volume expansion. Monitor patient for possible drop in BP secondary to reduction in fluid volume (excessive perspiration and dehydration, vomiting, diarrhea) because excessive hypotension may occur. BLACK BOX WARNING: Ensure that patient is not pregnant; fetal abnormalities and death

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Nursing Notes and Community

have occurred if used during second or third trimester. Encourage use of contraceptive measures. Reduce dosage in patients with impaired renal function. Teaching points Do not stop taking the medication without consulting your health care provider. Be careful in any conditions that may lead to a drop in blood pressure (such as diarrhea, sweating, vomiting, dehydration); if light-headedness or dizziness occurs, consult your health care provider. You should not become pregnant while on this drug. Serious fetal abnormalities could occur; use of contraceptives is advised. You may experience these side effects: GI upset, loss of appetite (transient effects; if persistent consult health care provider); lightheadedness (transient; change position slowly, and limit activities to those that do not require alertness and precision); dry cough (irritating but not harmful; consult health care provider). Report mouth sores; sore throat, fever, chills; swelling

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Nursing Notes and Community

of the hands, feet; irregular heartbeat, chest pains; swelling of the face, eyes, lips, tongue, difficulty breathing, persistent cough.

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