high blood pressure 14

4
high blood pressure 14 The lowering of even moderately elevated blood pressure can significantly reduce cardiovascular morbidity and mortality. Monitor blood pressure levels when beginning an antihypertensive drug and through titration, and periodically after desired hypertension is achieved. NON-PHARMACOLOGIC INTERVENTIONS: Advise all patients to prevent smoking, shed extra pounds, restrict dietary saturated fats and salt intake, limit alcohol, and fitness appropriately. Avoid estrogen-containing oral contraceptives; a progestin-only pill could be preferable. If blood pressure levels remains elevated and drug treatment is initiated, such lifestyle changes should be continued even. PHARMACOLOGIC INTERVENTIONS: See charts in this section. Doses of high blood pressure symptoms most drugs should be individualized. Visit www.eMPR.com for a whole http://dictionary.reference.com/browse/blood+pressure selection of antihypertensive medications. ACCUPRIL Pfizer Rx ACE inhibitor. Quinapril (as HCI) 5mg20mg, 10mg and 40mg; tabs; scored. Indications: Hypertension. Adults: Monotherapy: Once daily initially 10-20mg. Usual maintenance: 20-80mg daily in 1-2 divided doses. Elderly: initially 10mg once daily. Patients on diuretic: suspend diuretic for 2-three days before starting; resume diuretic if BP not controlled by quinapril alone. If diuretic should not be discontinued, or maybe creatinine clearance (CrCI) 30-60mL/min: initially 5mg daily. CrCI 10- 30mL/min: initially 2.5mg dally. Children: Not recommended.

Upload: plausibleoptimi12

Post on 19-Jul-2015

30 views

Category:

Health & Medicine


0 download

TRANSCRIPT

Page 1: high blood pressure 14

high blood pressure 14

The lowering of even moderately elevated blood pressure can significantly reduce cardiovascularmorbidity and mortality. Monitor blood pressure levels when beginning an antihypertensive drugand through titration, and periodically after desired hypertension is achieved.

NON-PHARMACOLOGIC INTERVENTIONS:

Advise all patients to prevent smoking, shed extra pounds, restrict dietary saturated fats and saltintake, limit alcohol, and fitness appropriately. Avoid estrogen-containing oral contraceptives; aprogestin-only pill could be preferable. If blood pressure levels remains elevated and drug treatmentis initiated, such lifestyle changes should be continued even.

PHARMACOLOGIC INTERVENTIONS:

See charts in this section. Doses of high blood pressure symptoms most drugs should beindividualized.

Visit www.eMPR.com for a whole http://dictionary.reference.com/browse/blood+pressure selectionof antihypertensive medications.

ACCUPRIL Pfizer Rx

ACE inhibitor. Quinapril (as HCI) 5mg20mg, 10mg and 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: suspend diuretic for 2-three daysbefore starting; resume diuretic if BP not controlled by quinapril alone. If diuretic should not bediscontinued, or maybe creatinine clearance (CrCI) 30-60mL/min: initially 5mg daily. CrCI 10-30mL/min: initially 2.5mg dally.

Children: Not recommended.

Page 2: high blood pressure 14

Contraindications: History of ACEI-associated or some other angioedema. Pregnancy (Cat.D in 3rdand 2nd trimesters).

Precautions: Salt/volume depletion. Renal or hepatic impairment. CHF. Dialysis (esp. high-fluxmembrane). Monitor renal function in severe CHF, hypertension, or renal artery stenosis. MonitorWBCs In renal or collagen vascular disease. Monitor for hyperkalemia in diabetics. Surgery.Discontinue if angioedema or laryngeal edema occurs. Pregnancy (Cat.C in 1st trimester). Nursingmothers.

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

Page 3: high blood pressure 14

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

How supplied: Tabs-90

ACEONSolvayRx

ACEinhibi

tor. Perindopril erbumine2mg and 4mg, 8mg; scored tabs.

Indications: Hypertension.

Adults: Otherwise on diuretic: Once daily or even in 2divided doses initially 4mg. Titrate; max 16mg/day.Once dally Usual maintenance 4-8mg. If on diuretic:suspend diuretic, if you can, 2-72 hours beforebeginning therapy. If diuretic can not be discontinued(monitor closely): Once daily or in 2 divided doses; max16mg/day initially 2-4mg. Renal impairment: CrCI<30mL/min: not recommended; CrCI>30mL/min:initially 2mg/day: max 8mg/day.

Children: Not recommended.

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

Contraindications: Past of ACEI-associated or another angioedema. Pregnancy (Cat.D In 3rd and 2nd

Page 4: high blood pressure 14

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