Nursing Medication Card - Ramipril (Kor/Eng)

Nursing Medication Card – Ramipril

약물명 (Drug Name): Ramipril (라미프릴)
상품명 (Brand Name): Altace (알타제)
약물분류 (Class): Antihypertensive / ACE Inhibitor (혈압강하제 / 안지오텐신 전환효소 억제제)

1. Indications (적응증)

• Hypertension (고혈압)
• Heart failure post-myocardial infarction (심근경색 후 심부전)
• Risk reduction of myocardial infarction, stroke, and death in high-risk patients
  (고위험 환자의 심근경색, 뇌졸중, 심혈관 사망 위험 감소)

2. Therapeutic Effects (치료 효과)

• Lowers blood pressure (혈압 감소)
• Improves survival after MI (심근경색 후 생존율 향상)
• Reduces progression of heart failure (심부전 진행 억제)
• Vasodilation and reduced workload on the heart (혈관 확장 및 심장 부담 감소)

3. Absorption (흡수)

• Oral bioavailability: ~50–60% (경구 흡수율 약 50–60%)
• Food may delay absorption but does not reduce effect (음식이 흡수 지연 가능성은 있으나 효과 감소는 없음)

4. Distribution (분포)

• Does not significantly enter breast milk
  (모유로 거의 전달되지 않음)

5. Metabolism & Excretion (대사 및 배설)

• Prodrug converted to active metabolite (ramiprilat) in the liver
  → 간에서 활성 대사체(ramiprilat)로 전환
• Excreted via urine and feces
  → 소변과 대변으로 배설
• Half-life: 13–17 hours (반감기: 13–17시간)

6. Adverse Effects (부작용)

Common:

• Hypotension (저혈압)
• Dizziness (어지러움)
• Cough (기침)

Serious (rare):

• Angioedema (혈관부종)
• Hyperkalemia (고칼륨혈증)
• Neutropenia/agranulocytosis (호중구감소증/무과립구증)

7. Dose (용량)

• Hypertension:
  PO: 2.5–5 mg once daily, up to 10 mg/day (1–2 divided doses)
• Heart failure post-MI:
  PO: Start 2.5 mg BID, increase as tolerated (최대 10 mg/day)
• Adjust dose in renal impairment
  (신장 기능 저하 시 용량 조절 필요)

8. Nursing Considerations (간호 고려사항)

• Monitor blood pressure regularly (혈압 자주 모니터링)
• Monitor renal function (BUN, creatinine) and electrolytes (특히 potassium)
  → 신장 기능 및 전해질 (특히 칼륨) 수치 확인
• Watch for signs of angioedema: facial/lip swelling, difficulty breathing
  → 얼굴, 입술 붓기, 호흡 곤란 시 즉시 보고
• Instruct patient not to use potassium supplements or salt substitutes containing potassium
  → 칼륨 보충제 또는 칼륨 함유 소금 대체제 사용 자제
• May cause persistent dry cough
  → 지속적인 마른 기침 유발 가능성 있음

 

Ramipril 

antihypertensives/ACE inhibitors

● Indications: management of HTN, reduction of risk of death or development of HF following MI 

● Therapeutic effects: lowering of BP, improved symptoms in patients w/ HF, lower risk of MI, stroke or death from CVD causes in high-risk patients 

● Absorption: 50-60% ac PO 

● Distribution: doesn’t enter breast milk 

● Protein binding: 

● Metabolism&Excretion: converted by liver to ramiprilat, active metabolite 

● ADE: CV; hypotension GI; taste disturbances Hemat; agranulocytosis Resp; cough Misc; angioedema

● Dose: PO; HTN-2.5-5 mg/day upto 40mg/day in 1-2 divided doses, IV; HTN-0.625-1.25mg Q6H (upto 5mg every 6hr)