Enalapril

Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.

Enalapril (brand name Vasotec) — Antihypertensive, heart failure agent; ACE inhibitor.

Identification

• Therapeutic class: Antihypertensive, heart failure agent.
• Pharmacologic class: ACE inhibitor.

Pharmacology

• Mechanism of action: Same as lisinopril; prodrug converted to active enalaprilat.
• Onset / peak / duration: PO onset about 1 hour, peak 4 to 6 hours, duration up to 24 hours; IV onset about 15 minutes.
• Half-life / therapeutic level: Half-life about 11 hours; no routine level.

Clinical use

• Indications: Hypertension, heart failure, asymptomatic left ventricular dysfunction.
• Usual dose, route, frequency: 5 to 40 mg PO daily in 1 to 2 doses; IV enalaprilat 1.25 mg every 6 hours.
• Maximum dose / adjustments: Max about 40 mg/day PO; reduce in renal impairment.

Safety

• Contraindications: Angioedema history, pregnancy, bilateral renal artery stenosis.
• Black box warning: Fetal toxicity; discontinue when pregnancy detected.
• Interactions: Same class effects as lisinopril.
• Pregnancy / lactation: Contraindicated.
• High-alert: No.

Adverse effects

• Common side effects: Cough, dizziness, hyperkalemia.
• Serious effects to report: Angioedema, hyperkalemia, renal failure.
• Antidote / reversal: None specific; supportive.

Nursing process

• Assessment before administration: Blood pressure, potassium, renal function, pregnancy status.
• Interventions during therapy: Monitor IV doses closely for hypotension.
• Monitor: Blood pressure, potassium, renal function.
• Evaluation / expected outcome: Blood pressure control; improved cardiac function.

Patient teaching

• Patient teaching: Same as lisinopril.
• Notify provider if: Facial/throat swelling, severe dizziness, signs of hyperkalemia.
• Administration tips: Consistent timing; protect from abrupt discontinuation.