The lowering of even moderately elevated blood pressure has been shown to significantly reduce cardi...

1. high blood pressure 18
The lowering of even moderately elevated blood pressure has been shown to significantly reduce
cardiovascular morbidity and mortality.
Monitor blood pressure levels when beginning an antihypertensive drug and through titration, and

2. 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 are
initiated, such change in lifestyle should http://readanddigest.com/blood-pressure/ be continued
even.
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 divided
doses. Elderly: Once daily initially 10mg. Patients on diuretic: Before starting; resume diuretic if BP
not controlled by quinapril alone, suspend diuretic for a couple of-72 hours. If diuretic cannot be
discontinued, or maybe creatinine clearance (CrCl) 30-60mL/min: initially 5mg daily. CrCl high blood
pressure symptoms in men 10-30mL/min: initially 2.5mg daily.

3. Children: Not advised.
Contraindications: Reputation of ACEI-associated or another angioedema. Pregnancy (Cat.D in 3rd
and 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 substitutes
can cause hyperkalemia. May increase lithium levels. Antagonizes tetracycline. Potentiated by
diuretics. Nitritoid reactions with concomitant injectable gold (eg, sodium high blood pressure
symptoms 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.

4. Adults: Or else on diuretic: initially 4mg once daily or perhaps in 2 divided doses. Titrate; max
16mg/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: not
recommended; CrCl>30mL/min: initially 2mg/day: max 8mg/day.
Children: Not suggested.
Elderly: >65 yrs: usual
max 8mg/day.
Contraindications: Past
of ACEI-associated or
some other
angioedema.
Pregnancy (Cat.D in
3rd and 2nd
trimesters).
Warnings/Precautions:
Renal or hepatic
impairment.
Salt/volume depletion.
Severe CHF. Renal
artery or aortic
stenosis. Monitor for neutropenia in renal or collagen vascular disease. Monitor for hyperkalemia in
diabetics. Dialysis. Surgery. Discontinue if laryngeal edema, angioedema, marked elevations of liver
enzymes 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, upper
extremity pain, fever, dyspepsia and proteinuria palpitations.