Look inside the book: Nursing 2025-2026 Drug Handbook

218 cangrelor

Musculoskeletal: backpain. Respiratory: URI. INTERACTIONS Drug-drug. ACE inhibitors, other ARBs: May increase risk of hypotension, hyper kalemia, and changes in kidney function (in cluding AKI) when used with other drugs that cause blockade of the RAAS. Consider ther apy modification. Aliskiren: May increase risk of kidney im pairment, hypotension, and hyperkalemia in patients with diabetes and those with GFR less than 60 mL/minute. Use together is con traindicated in patients with diabetes. Avoid use together in those with GFR less than 60 mL/minute. Lithium: May increase lithium level. Monitor lithium level closely. NSAIDs (celecoxib, ibuprofen): May decrease antihypertensive effect of candesartan. Coad ministration in patients who are volume depleted (including those taking diuretics) or with decreased kidney function and in older adults may result in deteriorating kidney function. Monitor BP and kidney function. Potassium-sparing diuretics, potassium sup plements: May cause hyperkalemia. Monitor patient closely. Drug-food. Salt substitutes containing potas sium: May cause hyperkalemia. Monitor pa tient closely. EFFECTS ON LAB TEST RESULTS • May increase potassium, BUN, and serum creatinine levels. • May cause false-negative aldosterone-to renin ratio. CONTRAINDICATIONS & CAUTIONS • Contraindicated in patients hypersensitive to drug or its components, in children with GFR of less than 30 mL/min/1.73 m 2 , and in children younger than age 1. • Use cautiously in patients whose kidney function depends on the RAAS (such as pa tients with HF) because of risk of oliguria and progressive azotemia with AKI or death. • Use cautiously in patients who are volume or salt depleted; may cause symptoms of hy potension. Start therapy with a lower dosage range, and monitor BP carefully. • Don’t use for HTN in children younger than age 1 because of potential effects on the de veloping immature kidneys.

• Dialyzable drug: No. • H Overdose S&S: Hypotension, dizziness, tachycardia; possible bradycardia from parasympathetic stimulation. PREGNANCY-LACTATION-REPRODUCTION Boxed Warning Drugs such as candesar tan that act directly on the RAAS can cause injury and death to a developing fetus. Dis continue candesartan as soon as possible if pregnancy occurs. • It isn’t known if drug appears in human milk. Use of drug during breastfeeding isn’t recommended. NURSING CONSIDERATIONS • Most of drug’s antihypertensive effect oc curs within 2 weeks. Maximal effect may take 4 to 6 weeks. Diuretic may be added if BP isn’t controlled by drug alone. • Monitor BP during dosage escalation and periodically thereafter. • If hypotension occurs after a candesartan dose, position patient supine and treat appro priately. • Periodically monitor kidney function and serum potassium level. PATIENT TEACHING Boxed Warning Inform patient of childbear ing potential of consequences of drug expo sure during pregnancy. Instruct patient to im mediately report suspected pregnancy. • Advise patient who is breastfeeding to dis cuss risks with prescriber. • Teach about proper drug administration and handling. • Inform patient to report all adverse reac tions without delay. cangrelor KAN-grel-or Kengreal Therapeutic class: Antiplatelet drugs Pharmacologic class: Platelet aggregation inhibitors AVAILABLE FORMS Lyophilized powder for injection: 50mg SAFETY ALERT!

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Reactions in bold italics are life-threatening .