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1. Trade Name- Capoten
2. Generic- Captopril 3. Classification-Reduction of risk of death or development of CHF following MI. 4. Available Doses- Hypertension- 12.5- mg 2-3 times daily, may be at 1-2 wk intervals up to 150 mg 3 times daily (begin with 6.25-12.5 mg 2-3 times daily in patients receiving diuretics) 5. Maximum Dose- = 450 mg/day 6.Contraindications- Hypersensitivity; History of angioedema with previous use of ACE inhibitors; OB: Can cause injury or death of fetus; Lactation: Certain ACE inhibitors appear in breast milk; discontinue drug or use formula. |
7. Adverse Affects- CNS: Dizziness, drowsiness, fatigue, headache, insomnia, vertigo, weakness.
8. Pt. Teaching- Be Aware of progression of diabetic nephropathy. |
1.Trade Name- Lisinopril
2. Generic- Prinivil, Zestril 3. Classification- Lisinopril is an angiotensin converting enzyme (ACE) inhibitor used for treating high blood pressure, heart failureand for preventing kidney failure due to high blood pressure and diabetes. Other ACE inhibitors include enalapril (Vasotec), quinapril (Accupril),captopril (Capoten), fosinopril (Monopril), benazepril (Lotensin), ramipril(Altace), moexipril (Univasc) and trandolapril (Mavik). 4. Available Doses- The starting dose of lisinopril is 5 mg daily, and the effective dose range for treating heart failure is 5-20 mg daily. The dose can be increased by 10 mg every 2 weeks to achieve the maximum effect. 5. Indication/Uses-Treatment of heart attack (myocardial infarction) is started with individual doses of 5 mg followed by 5 mg after 24 hours, 10 mg after 48 hours and then 10 mg daily. Treatment is continued for 6 weeks. |
6. Contraindications- In general, lisinopril should not be taken with potassium supplements or diuretics that conserve potassium, for example, hydrochlorothiazide/triamterene (Dyazide), since blood potassium levels may rise to dangerous levels.
7. Adverse Affects- The effects of ACE inhibitors are particularly beneficial to people withcongestive heart failure. In the kidneys, the narrowing of the arteries by angiotensin II decreases blood flow and damages the kidneys. ACE inhibitors enlarge and reduce the blood pressure in the arteries going to the kidney. This reduces damage to the kidneys caused by the high blood pressure. The FDA approved lisinopril in December 1987. 8. Pt Teaching- Lisinopril is used to treat elevated blood pressure, heart failure and to improve survival after a heart attack (myocardial infarction) |
1. Trade Name- Trandolapril
2. Generic- Mavik 3. Classification- Trandolapril can be used alone in treating high blood pressure. Its blood pressure lowering effect can be further enhanced by the addition of a diuretic medication ("water pill"), such as hydrochlorothiazide, or other antihypertensive medications. Trandolapril also is used for treatingcongestive heart failure. Use of trandolapril after a heart attack decreases the risk of death and hospitalizations related to heart failure. 4. Available Doses- The recommended starting dose for treating high blood pressure in patients not receiving a diuretic is 1 mg once daily in Caucasian patients and 2 mg in black patients. Doses may be increased at weekly intervals. Most patients require 2 to 4 mg daily, and there is no additional benefit from doses larger than 8 mg daily. Patients receiving a diuretic should start at 0.5 mg daily if the diuretic cannot be stopped for 2 to 3 days before starting trandolapril. For heart failure the starting dose is 1 mg once daily. The dose should be increased to 4 mg once daily or the largest tolerated dose. 5. Indication/ Uses- Trandolapril is an oral drug that is used to treat high blood pressure. It belongs to a class of drugs called angiotensin converting enzyme (ACE) inhibitors. |
6. Contraindications- Trandolapril and other ACE inhibitors can interact with diuretics to cause an excessive drop in blood pressure, causing symptoms of weakness, dizziness, and lightheadedness. This is most likely to occur when patients who are already taking a diuretic are started on an ACE inhibitor.
7. Adverse Affects- Combining trandolapril with potassium supplements, potassium containing salt substitutes, or potassium-conserving diuretics such as amiloride (Moduretic), spironolactone (Aldactone), and triamterene (Dyazide, Maxzide), can lead to dangerously high blood levels of potassium. It is recommended that trandolapril not be taken at the same time as aluminum- or magnesium- based antacids, such as Mylanta or Maalox; these antacids bind to trandolapril in the intestine and decrease its absorption into the body. 8. Pt Teaching- Therefore, patients should separate doses of antacids and trandolapril by at least two hours. |
1. Trade Name- Atropine
2. Generic- Atro-Pen 3. Classificatio- Treatment of sinus bradycardia and heart block. Reversal of adverse muscarinic effects of anticholinesterase agents. 4. Available Dose- 0.5-1mg; may repeat as needed q 5 min, not to exceed a total of 2 mg ( q 3-5 minin Advanced Cardiac Life Support guidelines) or 0.04 mg/kg ( total vagolytic dose). 5. Indication/ Use- Treatment of anticholinesterase (organophosphate pesticide) poisoning. |
6. Contraindicatio- Hypersensitivity; Angle- closure glaucoma; Acute hemorrhage; Tachycardia secondary to cardiac insufficiency or thyrotoxicosis; Obstructive disease of the GI tract.
7. Adverse Affects- Safety not established; IV administration may produce fetal tachycardia. 8. Pt Teachins - May cause drowsiness. Caution patients to avoid driving or other activities requiring alertness until response to medication is known. |
1. Trade Name- LIdocaine
2. Generic- Xylocaine 3. Classificatio- Ventricular arrhythmias.Suppressess automaticity and spontaneous depolarization of the ventricles during diastole by altering the flux of sodium ions across cell membranes with little or no effect on heart rate. 4. Available Dose- 1-1.5 mg/kg bolus; may repeat doses of 0.5-0.75 mg/kg q 5-10 min up to a total dose of 3 mg/kg; may then start continuous in fusion of 1-4 mg/min. 5.Indication/ Uses- Therapeutic: anesthetics ( topical/ local), antarrhymics. |
6. Contraindications- Hypersensity; cross-sensitivity may occur; Third- degree heart block.
7. Adverse Affects- Of toxicity include confusion, excitation, blurred or double vision, nausea, vomiting, ringing in ears, tremors, twitching, seizures, difficulty breathing, severe dizziness or fainting, and unusually slow heart rate. 8. Pt Teaching- May cause drowsiness and dizziness. Advise patient to call for assistance during ambulation and transfer. |