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Assessment & Drug Effects
 Monitor effectiveness of drug in relieving angina.
 Note: Headaches tend to decrease in intensity and frequency with continued therapy but may require
administration of analgesic and reduction in dosage.
 Note: Chronic administration of large doses may produce tolerance and thus decrease effectiveness of nitrate
preparations.
Patient & Family Education
 Make position changes slowly, particularly from recumbent to upright posture, and dangle feet and ankles before
walking.
 Lie down at the first indication of light-headedness or faintness.
 Keep a record of anginal attacks and the number of sublingual tablets required to provide relief.
 Do not drink alcohol because it may increase possibility of light-headedness and faintness.
 Do not breast feed while taking this drug without consulting physician.
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Assessment & Drug Effects
 Monitor BP for therapeutic effectiveness. BP reduction is greatest after peak levels of amlodipine are achieved 6±
9 h following oral doses.
 Monitor for S&S of dose-related peripheral or facial edema that may not be accompanied by weight gain; rarely,
severe edema may cause discontinuation of drug.
 Monitor BP with postural changes. Report postural hypotension. Monitor more frequently when additional
antihypertensives or diuretics are added.
 Monitor heart rate; dose-related palpitations (more common in women) may occur.
Patient & Family Education
 Report significant swelling of face or extremities.
 Take care to have support when standing & walking due to possible dose-related light-headedness/dizziness.
 Report shortness of breath, palpitations, irregular heartbeat, nausea, or constipation to physician.
 Do not breast feed while taking this drug without consulting physician.
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 Note: Frequency of blood glucose monitoring is determined by the type of insulin regimen and health status of the
patient.
 Lab tests: Periodic postprandial blood glucose, and HbA1C. Test urine for ketones in new, unstable, and type 1
diabetes; if patient has lost weight, exercises vigorously, or has an illness; whenever blood glucose is
substantially elevated.
 Notify physician promptly for presence of acetone with sugar in the urine; may indicate onset of ketoacidosis.
Acetone without sugar in the urine usually signifies insufficient carbohydrate intake.
 Monitor for hypoglycemia (see Appendix F) at time of peak action of insulin. Onset ofhypoglycemia (blood sugar:
50±40 mg/dL) may be rapid and sudden.
 Check BP, I&O ratio, and blood glucose and ketones every hour during treatment for ketoacidosis with IV insulin.
 Give patients with severe hypoglycemia glucagon, epinephrine, or IV glucose 10%±50%. As soon as patient is
fully conscious, give oral carbohydrate (e.g., dilute corn syrup or orange juice with sugar, Gatorade, or Pedialyte)
to prevent secondary hypoglycemia.
Patient & Family Education
 Learn correct injection technique.
 Inject insulin into the abdomen rather than a near muscle that will be heavily taxed, if engaged in active sports.
 Notify physician of local reactions at injection site; may develop 1±3 wk after therapy starts and last several hours
to days, usually disappear with continued use.
 Do not change prescription lenses during early period of dosage regulation; vision stabilizes, usually 3±6 wk.
 Note: Hypoglycemia can result from excess insulin, insufficient food intake, vomiting, diarrhea, unaccustomed
exercise, infection, illness, nervous or emotional tension, or overindulgence in alcohol.
 Respond promptly to beginning symptoms of hypoglycemia. Severe hypoglycemia is an emergency situation.
Take 4 oz (120 mL) of any fruit juice or regular carbonated beverage [1.5±3 oz (45±90 mL) for child] followed by a
meal of longer-acting carbohydrate or protein food. Failure to show signs of recovery within 30 min indicates need
for emergency treatment.
 Carry some form of fast-acting carbohydrate (e.g., lump sugar, Life-Savers or other candy) at all times to
treat hypoglycemia.
 Check blood glucose regularly during menstrual period; loss of diabetes control (hyperglycemia or hypoglycemia)
is common; adjust insulin dosage accordingly, as prescribed by physician.
 Notify physician of S&S of diabetic ketoacidosis.
 Continue taking insulin during an illness, go to bed, and drink noncaloric liquids liberally (every hour if possible).
Consult physician for insulin regulation if unable to eat prescribed diet.
 Avoid OTC medications unless approved by physician.
 Do not breast feed while taking this drug without consulting physician.
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