Mindanao State University – Iligan Institute of Technology Student: Portugaleza, Nicole Denise D.

Section: 260

PHARMACOLOGY

DRUG STUDY

Brand Name: Natrecor Generic Name: Nesiritide Drug classification: Atrial Natriuretic Peptide Hormones

Dosage, Route & Frequency
Drug Action
Recommended Prescribed
The recommended A form of the natural
dose of NATRECOR peptide produced in
is an IV bolus of 2 human ventricles-human
mcg/kg followed by a natriuretic peptide-
continuous infusion produced by recombinant
of 0.01 mcg/kg/min. DNA technology. Binds to
Do not initiate vascular smooth muscle &
NATRECOR at a endothelial cells causing
dose that is above smooth muscle relaxation
the recommended & dilation of veins &
dose. arteries. This dilation
results in a decrease in
The loading dose PCWP, decrease in
may not be systemic arterial pressure,
appropriate for those and a diuretic effect.
with low systolic
blood pressure (SBP) Route: IV
<110 mm Hg or for
patients recently Onset: Immediate
treated with afterload
reducers. Peak: 15 min
Metabolism: Tissue; T1/2:
18 min
Distribution: may cross
placenta; may enter breast
milk
Drug-Drug & Drug- Side Effects Adverse Reactions
Indications Contraindications
Food Interactions (By System) (By System)
Drugs that either IV treatment of Pts with allergy to any CV: hypotension CNS: headache,
increase effects of the patients w/ acutely components of the dizziness, insomnia,
other by decompensated CHF drug, w/ low cardiac GI: nausea anxiety
pharmacodynamic who have dyspnea at filling pressure, and
synergism. Use rest or with minimal as a primary therapy Musculoskeletal: CV: hypotension,
Caution/Monitor. activity for cardiogenic shock Back pain ventricular
Additive hypotensive tachycardia, angina,
effects. Use cautiously w/ CNS: headache, bradycardia
restrictive or dizziness
Benazepril, bretylium, obstructive GI: nausea, vomiting
captopril, enalapril, cardiomyopathy,
fosinopril, lisinopril, constrictive Other: abdominal
maraviroc, moexipril, pericarditis, pain, back pain
perindopril, quinapril, pericardial
ramipril, trandolapril tamponade, renal
dysfunction,
hypotension,
pregnancy, &
Increased risk of lactation
hypotension if given w/
other drugs that
decrease BP (ACE
inhibitors, possibly
nitrate vasodilators)

Excretion: urine
 Responsibilities in the Nursing Process (ADPIE) Responsibilities in the Nursing Process (ADPIE)
Assessment Teaching Points

 History: Presence of allergy to known components of the drug; CV disorders; renal
dysfunction, pregnancy, lactation
 Physical: P, BP, R, ECG, skin color, perfusion, PCWP, urinary output, renal function tests
Interventions
 This drug must be given by continuous intravenous infusion; you will be closely
monitored during the infusion & for several hours afterward.
 You may experience these side effects: Headache (an analgesic may be ordered for
you); nausea & vomiting (eat small freq meals); low BP (will be closely monitored)
 Report chest pain, changes in vision, dizziness, and palpitations.

 Monitor ECG, BP, & PCWP continually during administration & for several hours after
finishing infusion.
 Monitor urinary output & assess pt for hydration status.
 Arrange to discontinue drug if serious hypotension occurs; if drug is to be restarted, omit the
bolus dose & start drug at 30% dose & slowly titrate.
 Ensure that reconstituted solution is replaced q 24 hours.
 Provide small frequent meals if GI upset occurs.
 Arrange for nutritional consult if nausea & vomiting are persistent.