The nurse prepares to administer diltiazem (Cardizem LA) to an older adult with ischemic heart disease. When is the optimal time to administer this medication to help prevent complications of heart disease associated with rhythmical variations?
a. Midday c. At breakfast
b. At bedtime d. Every 4 hours
B
Diltiazem is a calcium-channel blocker used for hypertension, heart rate control, and angina from ischemic heart disease. To take advantage of rhythmical variations in heart disease, the best time to administer long-acting diltiazem (Cardizem LA) is at bedtime; the medication will then be ac-tive in the early morning hours when a cardiovascular event is most likely to take place. Midday administration is a less advantageous time for the medication administration because the main period of drug activity will occur in the evening. Morning administration is too late for adminis-tration because morning administration misses the critical period around 4 and 5 AM. Adminis-tering Cardizem LA every 4 hours is contraindicated because it is a long-acting formulation meant to be administered once daily.
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