high blood pressure 14

The lowering of even moderately elevated blood pressure levels has been shown to significantlyreduce cardiovascular mortality and morbidity. Monitor blood pressure levels when beginning anantihypertensive drug and through titration, and periodically after desired blood pressure levels isachieved.

NON-PHARMACOLOGIC INTERVENTIONS:

Advise all patients to quit smoking, shed extra pounds, restrict dietary saturated fats and salt intake,limit alcohol, and workout appropriately. Avoid estrogen-containing oral contraceptives; a progestin-only pill can be preferable. If blood pressure levels remains elevated and drug treatment methodsare initiated, such lifestyle changes needs to be continued even.

PHARMACOLOGIC INTERVENTIONS:

See charts with this section. Doses of most drugs oughtto be individualized.

Visit www.eMPR.com for a whole set ofantihypertensive medications.

ACCUPRIL Pfizer Rx

ACE inhibitor. Quinapril (as HCI) 5mg , 10mg and 20mg 40mg; tabs; scored.

Indications: Hypertension.

Adults: Monotherapy: Once daily initially 10-20mg. Usual maintenance: 20-80mg daily in 1-2 divideddoses. Elderly: initially 10mg once daily. Patients on diuretic: Prior to starting; resume diuretic if BPnot controlled by quinapril alone, suspend diuretic for two-three days. If diuretic should not bediscontinued, or maybe if creatinine clearance (CrCI) 30-60mL/min: initially 5mg daily. CrCI 10-30mL/min: initially 2.5mg dally.

Children: Not advised.

Contraindications: Reputation of ACEI-associated or other angioedema. Pregnancy (Cat.D in 2nd and3rd trimesters).

Precautions: Salt/volume depletion. Renal or hepatic impairment. CHF. Dialysis (esp. high-fluxmembrane). Monitor renal function in high blood pressure symptoms severe CHF, hypertension, orrenal artery stenosis. Monitor WBCs In renal or collagen vascular disease. Monitor for hyperkalemiain diabetics. Surgery. Discontinue if angioedema or laryngeal edema occurs. Pregnancy (Cat.C in 1sttrimester). Nursing mothers.

Interactions: [K.sup. ] supplements, [K.sup. ] sparing diuretics, [K.sup. ] containing salt substitutescould cause hyperkalemia. May increase lithium levels. Antagonizes tetracycline. Potentiated bydiuretics.

Negative effects: dizziness, cough, Headache and fatigue GI upset, hyperkalemia, lower back pain,tachycardia, dry mouth, somnolence, sweating, sinusitis.

How supplied: Tabs-90

ACEON Solvay Rx

ACE inhibitor. Perindopril erbumine4mgand 2mg, 8mg; scored tabs.

Indications: Hypertension.

Adults: If not on diuretic: Oncedaily or maybe in 2 divideddoses initially 4mg. Titrate;max 16mg/day. Usualmaintenance 4-8mg once dally.If on diuretic: If possible, 2-3days before beginning therapy,suspend diuretic. Ifhttp://www.blood-pressure-monitoring.org/ diuretic cannotbe discontinued (monitorclosely): initially 2-4mg oncedaily or perhaps in 2 divideddoses; max 16mg/day. Renalimpairment: CrCI <30mL/min:not recommended;CrCI>30mL/min: initially2mg/day: max 8mg/day.

Children: Not advised.

Elderly: >65 yrs: usual max 8mg/day.

Contraindications: Past of ACEI-associated or any other angioedema. Pregnancy (Cat.D In 3rd and2nd trimesters).

Precautions: Renal or hepatic Impairment. Salt/volume depletion. Severe CHF. Renal artery or aorticstenosis. Monitor for neutropenia in renal or collagen vascular disease. Monitor for hyperkalemia indiabetics. Dialysis. Surgery. Discontinue if laryngeal edema, angioedema, marked elevations of liverenzymes or jaundice occurs. Black patients may have higher risk of angioedema than non-blackpatients. Elderly. Pregnancy (Cat.C in 1st trimester). Nursing mothers.

Interactions: Excessive hypotension with diuretics. Hyperkalemia with [K.sup. ] supplements, [K.sup.] sparing diuretics, [K.sup. ] containing salt substitutes, others (eg, cyclosporine, indomethacin,heparin). May increase lithium levels. Caution with gentamicin, digoxin