Home Drug Guide Quinapril Hydrochloride

Drug Guide

Generic Name

Quinapril Hydrochloride

Brand Names Accupril

Classification

Therapeutic: Antihypertensive

Pharmacological: ACE Inhibitor (Angiotensin-Converting Enzyme Inhibitor)

FDA Approved Indications

  • Hypertension
  • Heart failure (as adjunct therapy)

Mechanism of Action

Quinapril inhibits angiotensin-converting enzyme (ACE), reducing the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. This results in vasodilation, decreased blood pressure, and decreased workload on the heart.

Dosage and Administration

Adult: Typically 10-40 mg once daily, titrated based on response.

Pediatric: Not generally recommended for children.

Geriatric: Start at lower doses due to increased sensitivity and risk of adverse effects.

Renal Impairment: Dosing adjustment is necessary, start with lower doses.

Hepatic Impairment: Use with caution; no specific dose adjustment established.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Wide tissue distribution, crosses placenta.

Metabolism: Partially metabolized in the liver to active metabolite quinaprilat.

Excretion: Primarily excreted by the kidneys, both parent and active metabolite.

Half Life: Approximately 2 hours for quinapril; active metabolite has a half-life of approximately 6 hours.

Contraindications

  • History of angioedema related to previous ACE inhibitor use
  • Bilateral renal artery stenosis
  • Hypersensitivity to quinapril or other ACE inhibitors

Precautions

  • Pregnancy (discontinue as soon as pregnancy is detected)
  • Renal impairment
  • Hypotension
  • Hyperkalemia

Adverse Reactions - Common

  • Cough (Common)
  • Dizziness (Common)
  • Headache (Common)
  • Fatigue (Common)

Adverse Reactions - Serious

  • Angioedema (Rare, but serious)
  • Hyperkalemia (Uncommon)
  • Hypotension (Uncommon)
  • Renal function decline (Uncommon)

Drug-Drug Interactions

  • Diuretics (potassium-sparing or thiazide)
  • Potassium supplements or potassium-containing salt substitutes
  • Other antihypertensives (additive hypotensive effect)
  • NSAIDs (may reduce antihypertensive effect and impair renal function)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure, renal function (BUN, serum creatinine), and electrolytes regularly.

Diagnoses:

  • Ineffective tissue perfusion related to decreased cardiac output
  • Risk for electrolyte imbalance

Implementation: Administer medication consistently at the same time daily, monitor for adverse effects, advise patient to rise slowly from sitting or lying position.

Evaluation: Assess blood pressure response, renal function, and electrolyte levels to evaluate effectiveness and safety.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Do not increase or decrease dose without consulting healthcare provider.
  • Report signs of angioedema (swelling of face, lips, tongue, or throat), severe dizziness, or hyperkalemia.
  • Avoid potassium supplements and potassium-rich foods unless directed.
  • Notify provider if pregnant or planning to become pregnant.

Special Considerations

Black Box Warnings:

  • Fetal toxicity when used during pregnancy, particularly in the second and third trimesters.

Genetic Factors: N/A

Lab Test Interference: May cause increases in serum potassium and BUN/creatinine levels.

Overdose Management

Signs/Symptoms: Severe hypotension, hyperkalemia, renal failure.

Treatment: Discontinue medication, supportive care, and symptomatic treatment. Consider administration of vasopressors for hypotension. Dialysis may be necessary in renal failure.

Storage and Handling

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

Stability: Stable at room temperature, protect from moisture.

🛡️ 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.