A question regarding to Diovan...

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Yesterday, my patient b/p was 132/76 and her pulse was 40x/minute. Should I give Diovan 25 mg tablet to that patient because of the low pulse rate. I asked other nurses and I got two different answers: one said "yes" and the other said "no." :banghead:

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Specializes in Acute Care Cardiac, Education, Prof Practice.

When in doubt call pharmacy, or heck even call the doc and just ask if they want a specific parameter. 40 is pretty brady, but I don't have a ton of experience with the effects of Diovan. I will have to look it up!

Tait

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Specializes in ICU.

Diovan has no effect on HR. It blocks angiotensin II. When in doubt, look it up.

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Specializes in Public Health, TB.

Diovan or valsartan is an angiotension receptor blocker(ARB). It lowers blood pressure and interrupts the RAS/RAAS, both of which are important to the hypertensive and/or heart failure patient. It does not lower heart rate, so yes you should give it.

I suspect your patient is also receiving a beta blocker and this may be lowering the heart rate.

Your are right to question the heart rate and some things to consider and perhaps discuss with the MD: is the patient symptomatic? Are they in a sinus rhythm? What is their normal HR? They may need a dose reduction, or a pacemaker.

We treat many chronic heart failure patients who live with a pulse of 50 and a BP of 85/50. As long as their SBP is >80 and they are assymptomatic they get their meds. And we always notify the cardiologist if meds are held.

Hope this helps.

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The patient was asymptomatic. Denied any chest pain and she was breathing on room air. The heart rate was not regular and the patient also has the Betimol 1 drop to right eye twice daily for Glaucoma. I did not give the eye drop to her.

By the way, this was a skilled nursing facility; so a doctor was not available and it was 6 a.m. in the morning. Even if I called the doctor; he would not return the call until after 8 a.m. I checked the drug book but the drug book was dated back to 2004.

Thank you to those who responded to my question. Have a good day.

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Specializes in Public Health, TB.

Oops, My bad.:smackingf

I just remembered to also consider whether the pt. is on dig. or other anti-arrhythmics, like diltiazem. When you mentioned an irregular pulse that's when I remembered.

If your patient has a continually low pulse rate it would be nice for the doc to write parameters for when she expects meds to be held and/or when to notify.

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Specializes in Acute Care Cardiac, Education, Prof Practice.

Why wouldn't you give the eye drop?

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nursej22

She was not receiving any antiarrhythmic drugs such as Diltiazem. I will definitely leave a message to the doctor tomorrow asking him to give the order for the parameters when he feels the meds to be held or notified. Thanks!

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The eye drops slow the heart rate so I did not give the eye drops! I was told not to give it! The nurse working the previous shift did not give it because the patient's heart rate was 39x/min!

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Specializes in Acute Care Cardiac, Education, Prof Practice.
The eye drops slow the heart rate so I did not give the eye drops! I was told not to give it! The nurse working the previous shift did not give it because the patient's heart rate was 39x/min!

I learn something new every day!

Tait

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