Pharmacology Antihypertensives #12

Question

The nurse on the medical surgical unit is providing discharge instructions for a patient diagnosed with hypertension and cardiovascular disease. Which important diet instructions is priority for the patient who will be discharged with amlodipine?

Answers

  1. Take amlodipine with a low fat meal.
    • Rationale:

      This answer is not correct because although a low-fat meal is encouraged for patients with cardiovascular disease and hypertension, it is not the priority teaching regarding food-drug interactions. Grapefruit should be avoided when taking this medication since it can increase the blood level of this drug, causing an unsafe drop in blood pressure.

  2. Be careful with too much sodium in the diet.
    • Rationale:

      This answer is not correct because although a low sodium diet is encouraged for patients with cardiovascular disease and hypertension, it is not the priority teaching regarding food-drug interactions. Grapefruit should be avoided when taking this medication since it can increase the blood level of this drug, causing an unsafe drop in blood pressure.

  3. If taken at breakfast, so not consume grapefruit.
    • Rationale:

      This answer is correct because grapefruit should be avoided when taking this medication since it can increase the blood level of this drug, causing an unsafe drop in blood pressure. Patients should be taught this important food-drug interaction.

  4. Take with bananas to aid in maintaining potassium.
    • Rationale:

      This answer is not correct because calcium channel blockers, such as amlodipine, may increase potassium levels. Therefore, increasing bananas may further increase potassium levels.

Overview

Calcium channel blockers, such as amlodipine, should not be taken with grapefruit since it will interact and increase the level of medication in the blood.

Explanation

The answer is C. Calcium channel blockers such as amlodipine should not be taken with grapefruit because the grapefruit will alter the effects of the drug. While eating low fat, low salt diets are beneficial for cardiac disease, the question pertains to taking a calcium channel blocker. Eating bananas with calcium channel blocker has not been proven to affect the electrolyte. Adverse side effects with renal disease may affect potassium movement, but it is not a common effect. If the effect occurs, potassium may actually be increased, not decreased (again is not a common finding.)

Learning Outcomes

Amlodipine is a calcium channel blocker prescribed to treat hypertension and cardiac disease. This medication reduces the pressure within the blood vessel which causes the blood pressure to decrease, increase flow of blood, and increase oxygen to the heart. Grapefruit should be avoided when taking this medication since it can increase the blood level of this drug, causing an unsafe drop in blood pressure. Patients should be taught this important food-drug interaction.

Test Taking Tip

Unless a medication (such as iron preparations) needs vitamin C to help it absorb, grapefruit or grapefruit juice could be basically avoided with most medications since it is a common food-drug interaction. If the patient loves grapefruit, then carefully check each medication to see if there is a food-drug interaction.

Video Rationale