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* Inhibts
Antiogensen Conversion >
-
Inhibte
Antigensen 11
Hypertension- 55
- Prevention
>
- Secondary
Decrease Infarction
ADH Decrease vasoconstriction
Myocardial S h o r t-te r m must be
heamodynamically
-
Stable
↓ Decrease aldosterone
Decree
20 ↳ ↓ Total peripheral
Nattzoreabsorption resistana re Renal Complication of Diabetes Mellitus
* Low and Slow >
-
Avoid
hypotensionSysidroa b
HTN-lOmg
3 80mg may
* OD inital - At bedtime
1Omg
OD Mainee
diuretic-2 55 mgoDivitazong ,
a
.
Another Safter first
* MI
Systolic BP > 120 - Smg within 24 hours - done
>
-
long after second dose - Maintained for 6 We e ks
CONTRAINDICATIONS : > Reduce to 5 or 2 5 it BP <100
-
.
* Renal Complications in DM 2 Op-oInital
5-5mg
- .
Black African
Hereditary /idiopathic angioedema African-Caribbean Usual
10-20mg OD Based
*
> dose
or response
-
-> - on
-
* eGFR < 60mL/min Elderly
* Hear t Failure/adjunct 2 OD Stepped
33Smaa
Inital
Smg
>
-
-
. - up
Combination weems
e
* With aliskiren i n DM
long at 2
>
least
-
every
Prosistent
typotention
a
*
Elderly with
-Hyperkalaemia
a
* ConditionArticsens hypertension
↳Pregnaa , ma
INTERACTIONS ROUTE OF ADMIN T PHARMACOKINETICS
ALISKERIN Risk of impairment
hypokalemia hypotension + renal
-
,
DIURETICS -
Rapid fall in BP in volume-depleted patient * Oral -- 25 %
Bioavailability
-
> Initiate at low close
=PeakPlasma
o a
ALLOPURINRiskLeucopeiathypersensitive it
* Water soluble metabolized
Not
by Liver
->
NSAIDS - Risk
of renal impairment + c a n cancel out
antihypertensive effectn
>
-
Renal excretion
unchanged
MTORINHIBTORS ↑Risk
of angio-oedema
-
SUNORA Hypoglycaemic
eft
HEPARIN -
Hyperkalemia
be uned after 36 hours
SACBUTRIL - Can
only of dose
SPIRONOLACTONE - Risk of
hyperkaldenia
COUNSELING POINTS+ MONITORING ADVERSEEFICTS :
* With or without food
COMMON
Common AgranRetosis
-
* First dose before bed >
Hypotension
*
Angio-odema * Namea
injit
-
*
Alopecia * Palpitation
* Whole drink
of water * Hepatitis
AngieaRenalimpair
a
Misseddo As sonanYourember a
double do ,
* Fever
unction
eucope
a
zay
↳ n a
Dysphagia
*
Pancytopenia
Heamolytic andemia
.
* Stand up Slowly *
*
Photosensitivity *
Hyperhidrosis Thrombocytopeninaen syndrome
Phil
* Contact doctor
Dry Cough ->
ora
* Check BP often
* MI
MONITORING * Stroke
Realfunction3 Before and
during treate a
* Gl discomfort
, DRUG : Losartan CIASS : ARB
MECHANISM OF ACTION INDICATION FOR USE :
Reversible competitive binds to AT1 to b l o c k
antigens i n I ① Diabetic
neuropatry in
Type
2
↓
cares vascular smooth muscle ② Chronic HF when Acti are unsuitable
relaxation =
NBP
③ HTN ->
including strove risk reduc tion
④ HIN with intravascular volume depletion
CONTRAINDICATIONS : DOSAGES :
eGFR
Patents
less than
on
60mL/min/1 73 m2
aliskiren >
-
DM .
.
①autnitogndetogoD
Pregnancy - ② Initial 12 .
5mg OD - & to up to
150mg at
weekly
intervals .
CAUTIONS ③tautitaSongtimea
Masterial ④ Initial
25mg
OD > to
100mg
if needed.
-
hypona
Bach Africaria
a
INTERACTIONS ROUTE OF ADMIN T PHARMACOKINETICS
AliskerRiskfyanSe
Acti 33 % Oral
+
bioavalability
Tmax
of
3-4 hous (AP)
>M Risk (YP450s
Diuretics
of
volume depletion
+they potension Metabolised
by
-
6-9
Lithium >
-
↑ Serum lithium concentration Half life hours
NSAIDS/COX2 inhibitors + ↑
Worsening of renal function -
Hyperkalemia
COUNSELING POINTS :
COMMON AE MONITORING COUNSELLING
rain
is Pottasium levels Before Bedtime first dom
↳Dizzinesa
↳
Espically i n elderly +
re n a l impairment
sometime
Ma
Missed
a
a
doseTake S bu dose
Don't step abruptly.
Namea +
Vomiting
paina
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