A question regarding to Diovan...

Nurses General Nursing

Published

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:

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

Specializes in ICU.

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

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.

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.

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.

Specializes in Acute Care Cardiac, Education, Prof Practice.

Why wouldn't you give the eye drop?

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!

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!

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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