high blood pressure 14

The lowering of even moderately elevated blood pressure levels has been shown to significantly reduce cardiovascular mortality and morbidity. Monitor blood pressure levels when beginning an antihypertensive drug and through titration, and periodically after desired blood pressure levels 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 progestinonly pill can be preferable. If blood pressure levels remains elevated and drug treatment methods are initiated, such lifestyle changes needs to be continued even.

PHARMACOLOGIC INTERVENTIONS: See charts with this section. Doses of most drugs ought to be individualized. Visit www.eMPR.com for a whole set of antihypertensive medications.

ACCUPRIL Pfizer Rx ACE inhibitor. Quinapril (as HCI) 5mg , 10mg and 20mg 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: Prior to starting; resume diuretic if BP not controlled by quinapril alone, suspend diuretic for two-three days. If diuretic should not be discontinued, or maybe if creatinine clearance (CrCI) 30-60mL/min: initially 5mg daily. CrCI 1030mL/min: initially 2.5mg dally. Children: Not advised. Contraindications: Reputation of ACEI-associated or other angioedema. Pregnancy (Cat.D in 2nd and 3rd trimesters). Precautions: Salt/volume depletion. Renal or hepatic impairment. CHF. Dialysis (esp. high-flux membrane). Monitor renal function in high blood pressure symptoms severe CHF, hypertension, or renal artery stenosis. Monitor WBCs 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). Nursing mothers.

Interactions: [K.sup. ] supplements, [K.sup. ] sparing diuretics, [K.sup. ] containing salt substitutes could cause hyperkalemia. May increase lithium levels. Antagonizes tetracycline. Potentiated by diuretics. Negative effects: dizziness, cough, Headache and fatigue GI upset, hyperkalemia, lower back pain, tachycardia, dry mouth, somnolence, sweating, sinusitis. How supplied: Tabs-90 ACEON Solvay Rx

ACE inhibitor. Perindopril erbumine4mg and 2mg, 8mg; scored tabs.

Indications: Hypertension. Adults: If not on diuretic: Once daily or maybe in 2 divided doses initially 4mg. Titrate; max 16mg/day. Usual maintenance 4-8mg once dally. If on diuretic: If possible, 2-3 days before beginning therapy, suspend diuretic. If http://www.blood-pressure-mo nitoring.org/ diuretic cannot be discontinued (monitor closely): initially 2-4mg once daily or perhaps in 2 divided doses; max 16mg/day. Renal impairment: CrCI <30mL/min: not recommended; CrCI>30mL/min: initially 2mg/day: max 8mg/day.

Children: Not advised. Elderly: >65 yrs: usual max 8mg/day. Contraindications: Past of ACEI-associated or any other angioedema. Pregnancy (Cat.D In 3rd and 2nd trimesters).

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 may 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