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20 Cards in this Set
- Front
- Back
- 3rd side (hint)
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ACEI
ACE inhibitors block conversion of angiotensin I to angiotensin II reduce the effects of angiotensin II-induced vasoconstriction, sodium retention and aldosterone release. SE: COUNSELLING |
SE;
hypotension hyperkalaemia cough(inhibit the breakdown of bradykinin) dizziness fatigue renal impairment angioedema anaphylactoid reactoins taste disturbance (metallic) |
11, 12+, 16
! If swelling of face, lips or tongue is experienced, seek medical advice |
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ACEI practice points
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Practice points:
- start low and go slow - BP should be closely monitored during initiation of therapy - monitor renal function and K - caution if patient is taking NSAIDs and/or lithium - can cause dry cough - risk of hyperkalaemia when used in combination with other drugs which can increase potassium concentration – Ksparring diuretic, AT2RA, NSAIDS, potassium supplements, cyclosporin |
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MONITORING ACEI & SARTANS
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blood electrolytes
- including K - hyperkalemia - BP - RF |
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ACEI Indications
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Hypertension
Heart Failure (all except 7) Diabetic nephropathy and prevention of progressive renal failure in patients with persistent proteinuria (1) Post MI (1, 3, 7) Reduction of risk of cardiovascular events in specific patients (1, 4) Asymptomatic left ventricular dysfunction (2) |
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1. Ramipril (Tritace, Ramace)
1.25, 2.5, 5, 10 mg |
1.25 – 10 mg daily
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2. Enalapril (Renitec)
2.5, 5, 10, 20 mg |
2.5 – 40 mg daily
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3. Lisinopril
5, 10, 20 mg |
2.5 – 40 mg daily
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4. Perindopril (Coversyl)
2.5, 5, 10 mg |
2.5 – 10 mg daily
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5. Fosinopril (Monopril, Monoplus)
10, 20 mg |
5 – 40 mg daily
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6. Quinapril (Accupril)
5, 10, 20 mg |
5 – 40 mg daily
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7. Trandolopril (Gopten)
0.5, 1, 2 mg |
0.5 – 4 mg daily
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8. Captopril (Capoten, Acenorm)
12.5, 25, 50 mg |
start with 12.5mg 2-3 times
day (m=150mg/day) |
3b
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AT2RA
inhibit angiotensin II from binding to AT1 receptors therefore reducing angiotensin-induced 1. vasoconstriction, 2. Na+ reabsorption and 3. aldosterone release |
SE: same as ACEI, no cough
first dose hypotension hyperkalaemia dizziness headache renal impairment angioedema cough (rarely) taste disturbance (metallic) |
11, 12+, 16+
! take tablet at the same time each day ! If persistent cough, or swelling of lips, face, or tongue experienced, seek medical advice ! avoid consuming foods high in K+ |
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AT2RA Practice Points
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- start low and go slow
- BP should be closely monitored during initiation of therapy - monitor renal function and K - caution if patient is taking NSAIDs and/or Li - can cause dry cough – if productive more likely infection or HF ! see doctor Start low and go slow esp. if old, renal imp, HF or taking diuretics |
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AT2RA Indications
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Hypertension
# progression of renal disease in T2DM, HT & microalb/proteinuria (avapro and cozaar) HF in pts intolerant to ACEIs (Atacand®) |
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Candesartan (Atacand®)
4, 8, 16, 32 mg 16/12.5 |
8 – 32 mg daily
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Telmisartan (Micardis®)
40, 80 mg +12.5 HCT for both |
20 – 80mg d
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Irbesartan (Avapro®, Karvea®)
75, 150, 300 mg 150 & 300/12.5 |
75 – 300mg d
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Losartan (Cozaar®)
50 mg |
50 – 100mg d
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Eprosartan (Teveten®)
400, 600 mg 600/12.5 |
600mg d
(m=800 mg/day) |
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