Acepril 10mg 14pcs

Indications

Hypertension: Lisinopril is indicated for the treatment of hypertension in adult and pediatric patients 6 years of age and older to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, mainly strokes and myocardial infarctions. These benefits have been observed in controlled trials of antihypertensive agents of various pharmacological classes.

Control of arterial hypertension should be part of overall cardiovascular risk management, including lipid control, diabetes management, antithrombotic therapy, smoking cessation, exercise, and restriction. amount of sodium. Many patients will need more than one medication to reach their blood pressure goals. For specific guidance on goals and management, see published guidelines, such as the National Joint Committee on the Prevention, Detection, Evaluation, and Treatment of Hypertension (JNC) National High Blood Pressure Education Program.

Many antihypertensive drugs, belonging to different pharmacological classes and with different mechanisms of action, have been shown in randomized controlled trials to reduce cardiovascular morbidity and mortality and can conclude that they are 'lower blood pressure and not some other pharmacological property. drugs are largely responsible for these benefits. The largest and most consistent cardiovascular benefit was a reduction in stroke risk, but reductions in myocardial infarction and cardiovascular mortality were also consistently observed.

High systolic or diastolic blood pressure leads to an increased cardiovascular risk, and the increase in absolute risk per mmHg is greater at higher blood pressure, so even a small reduction in severe hypertension can bring significant benefits. The relative reduction in risk of hypotension was similar in different absolute-risk populations, so the absolute benefit was greater in patients at higher risk regardless of whether they had hypertension (eg. patients with high blood pressure) or patients with diabetes. or hyperlipidemia), and these patients would benefit from more aggressive treatment to achieve the goal of lowering blood pressure.

Some antihypertensive drugs have a weaker effect on blood pressure (as monotherapy) in black patients, and many antihypertensive agents have been approved for additional indications and effects (as monotherapy). for example, for angina, heart failure, or diabetic kidney disease). These considerations can guide the choice of treatment.

Lisinopril may be used alone or with other antihypertensive agents.

Heart Failure: Lisinopril is indicated for the relief of signs and symptoms of heart failure in patients who have not responded adequately to diuretics and digitalis.

Acute Myocardial Infarction: Lisinopril is indicated for the reduction of mortality in the treatment of hemodynamically stable patients within 24 hours of acute myocardial infarction. Patients should receive recommended standard therapies, if appropriate, such as thrombolytics, aspirin, and beta-blockers.

Pharmacology

Lisinopril competitively inhibits ACE for the conversion of angiotensin I to angiotensin II (a potent vasoconstrictor), resulting in increased plasma renin activity and decreased secretion of aldosterone (a hormone that causes sodium and water retention). This promotes vasodilation and decreases BP.

Dosage & Administration

Oral (Adult) :

Hypertension: Initially 10 mg/day, preferably at bedtime to avoid hypotension. Patients with vascular HTN, volume depletion, severe HTN: Initially 2.55 mg x once / day. Patients on diuretics: Initially, 5 mg once daily. Maintenance: 20 mg once / day, up to 80 mg/day if necessary.

Diabetic nephropathy: hypertensive type 2 diabetic patients with microalbuminuria: 10 mg once daily, may be increased to 20 mg once daily to achieve sitting diastolic BP

Heart failure: adjuvant: initial, 2.5 or 5 mg/day, gradually increased to ≤ 10 mg at least 2 weeks apart to a maximum maintenance dose of 40 mg/day.

Post-myocardial infarction: Initially, 5 mg once daily for 2 days beginning within 24 hours of the onset of symptoms. Increase to 10 mg x once / day. Patients with low systolic BP: Initially 2.5 mg once daily.

 Oral (children) :

Hypertension: ≥ 6 years Initially 0.07 mg/kg, maximum 5 mg once daily.

Interaction

Diuretics may enhance the hypotensive effect. NSAIDs, it may increase the risk of renal function deterioration and reduce the antihypertensive effect. Lithium toxicity and serum levels may be affected. Hyperkalemia is a risk with K-sparing diuretics and K supplements. Gold Na thiomalate nitrite reactions may be boosted.

Contraindications

Previous ACE inhibitor treatment-related angioedema, hereditary or idiopathic angioedema. In patients with diabetes or renal impairment, aliskiren should be used together. Pregnancy. Children with a GFR of less than 30 mL/min/1.73 m2

Side Effects

Headache, fatigue, chest and abdominal pain, dizziness, nausea, vomiting, diarrhea, upper respiratory tract infection, asthenia, rash, orthostatic effects, hypotension, renal dysfunction, hyperkalemia, intestinal angioedema; increased BUN and serum creatinine levels.

Pregnancy & Lactation

Category D: Although there is evidence of human fetal risk, the benefits of use in pregnant women may outweigh the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).

Precautions & Warnings

Bilateral renal artery stenosis or unilateral renal artery stenosis in a single kidney. Patients with collagen vascular disease, and acute MI are at risk of worsening hemodynamics, angioedema not related to ACE inhibitor therapy, aortic stenosis, and hypertrophic cardiomyopathy. Angioedema risk is higher in black patients. Renal insufficiency. Lactation. 6 yr. old child

Storage Conditions

Store at a temperature of less than 25° C.