high blood pressure 18

The lowering of even moderately elevated blood pressure has been shown to significantly reducecardiovascular 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 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 might be preferable. If hypertension remains elevated and drug treatment methods areinitiated, such change in lifestyle should http://readanddigest.com/blood-pressure/ be continuedeven.

PHARMACOLOGIC INTERVENTIONS:

See charts within this section. Doses of drugs must be individualized.

Visit www.eMPR.com for an entire list of antihypertensive medications.

ACCUPRIL Pfizer Rx

ACE inhibitor. Quinapril (as HCl) 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: Once daily initially 10mg. Patients on diuretic: Before starting; resume diuretic if BPnot controlled by quinapril alone, suspend diuretic for a couple of-72 hours. If diuretic cannot bediscontinued, or maybe creatinine clearance (CrCl) 30-60mL/min: initially 5mg daily. CrCl high bloodpressure symptoms in men 10-30mL/min: initially 2.5mg daily.

Children: Not advised.

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

Warnings/Precautions: Salt/volume depletion. Renal or hepatic impairment. CHF. Dialysis (esp. high-flux membrane). Monitor renal function in severe CHF, hypertension, or renal artery stenosis.Monitor WBCs in renal or collagen vascular disease. Monitor for hyperkalemia in diabetics. Surgery.Discontinue if angioedema, laryngeal edema, jaundice or marked elevation in liver enzymes occurs.Pregnancy (Cat.C in 1st trimester). Nursing mothers.

Interactions: [K.sup. ] supplements, [K.sup. ] sparing diuretics, [K.sup. ] containing salt substitutescan cause hyperkalemia. May increase lithium levels. Antagonizes tetracycline. Potentiated bydiuretics. Nitritoid reactions with concomitant injectable gold (eg, sodium high blood pressuresymptoms aurothiomalate); rare.

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

How supplied: Tabs--90

ACEON Solvay Rx

ACE inhibitor. Perindopril erbumine2mg and 4mg, 8mg; scored tabs.

Indications: Hypertension.

Adults: Or else on diuretic: initially 4mg once daily or perhaps in 2 divided doses. Titrate; max16mg/day. Usual maintenance 4-8mg once daily. If on diuretic: suspend diuretic, if at all possible, 2-72 hours before you start therapy. If diuretic cannot be discontinued (monitor closely): initially 2-4mg once daily or even in 2 divided doses; max 16mg/day. Renal impairment: CrCl <30mL/min: notrecommended; CrCl>30mL/min: initially 2mg/day: max 8mg/day.

Children: Not suggested.

Elderly: >65 yrs: usualmax 8mg/day.

Contraindications: Pastof ACEI-associated orsome otherangioedema.Pregnancy (Cat.D in3rd and 2ndtrimesters).

Warnings/Precautions:Renal or hepaticimpairment.Salt/volume depletion.Severe CHF. Renalartery 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 could possibly have higher risk of angioedema than non-black patients. 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.

Adverse reactions: sinusitis, dizziness, Headache and cough viral infection, hypertonia, upperextremity pain, fever, dyspepsia and proteinuria palpitations.