Home Drug Guide Nadolol

Drug Guide

Generic Name

Nadolol

Brand Names Corgard

Classification

Therapeutic: Antianginal, Antihypertensive

Pharmacological: Beta-adrenergic blocker (non-selective)

FDA Approved Indications

  • Hypertension
  • Angina pectoris
  • Migraine prophylaxis

Mechanism of Action

Nadolol is a non-selective beta-adrenergic blocker that inhibits beta-adrenergic receptors in the heart and blood vessels, leading to decreased heart rate, myocardial contractility, and blood pressure, thereby reducing oxygen demand and alleviating angina.

Dosage and Administration

Adult: Initially 40 mg once daily; may increase to 120-160 mg once daily based on response.

Pediatric: Use is not well established; consult specific guidelines.

Geriatric: Start at lower doses due to increased sensitivity; monitor for adverse effects.

Renal Impairment: Adjust dose based on renal function, as nadolol is excreted renally.

Hepatic Impairment: No specific adjustment required, but monitor closely.

Pharmacokinetics

Absorption: Well absorbed orally, with peak plasma levels in 2-4 hours.

Distribution: Widely distributed; crosses the placenta and enters breast milk.

Metabolism: Minimal hepatic metabolism.

Excretion: Primarily unchanged in urine.

Half Life: 12-24 hours

Contraindications

  • Sinus bradycardia
  • Second- or third-degree AV block
  • Cardiogenic shock
  • Severe form of peripheral arterial circulatory disturbances

Precautions

  • Asthma or other bronchospastic conditions
  • Diabetes mellitus (may mask hypoglycemia symptoms)
  • Thyrotoxicosis (may mask symptoms)

Adverse Reactions - Common

  • Bradycardia (Common)
  • Fatigue (Common)
  • Dizziness (Common)
  • Gastrointestinal disturbances (Common)

Adverse Reactions - Serious

  • Severe bradycardia or heart block (Rare)
  • Bronchospasm in asthma patients (Rare)
  • Hypoglycemia masking in diabetics (Rare)

Drug-Drug Interactions

  • Calcium channel blockers (e.g., verapamil, diltiazem) - may increase risk of bradycardia and AV block.
  • Other antihypertensives - additive effects.

Drug-Food Interactions

  • No significant interactions noted.

Drug-Herb Interactions

  • Caution with herbal supplements affecting blood pressure or heart rate.

Nursing Implications

Assessment: Monitor blood pressure, heart rate, and for signs of heart failure.

Diagnoses:

  • Risk for decreased cardiac output
  • Ineffective tissue perfusion

Implementation: Administer without regard to meals; monitor vitals regularly; caution in starting or stopping therapy to avoid rebound hypertension or angina.

Evaluation: Assess blood pressure and heart rate for therapeutic response and adverse effects.

Patient/Family Teaching

  • Instruct patient to take medication exactly as prescribed.
  • Advise to rise slowly to prevent orthostatic hypotension.
  • Warn about symptoms of bradycardia (e.g., dizziness, weakness).
  • Notify provider if experiencing symptoms of asthma or unusual fatigue.

Special Considerations

Black Box Warnings: N/A

Genetic Factors: No specific genetic considerations.

Lab Test Interference: May affect certain lab results, such as blood glucose levels.

Overdose Management

Signs/Symptoms: Severe bradycardia, hypotension, bronchospasm, hypoglycemia.

Treatment: Discontinue medication, provide supportive care (e.g., IV fluids, atropine for bradycardia), and consider dialysis in severe cases.

Storage and Handling

Storage: Store at room temperature, away from moisture and heat.

Stability: Stable for 2-3 years when properly stored.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.