high blood pressure 14

The lowering of even moderately elevated blood pressure level can significantly reduce cardiovascular mortality and morbidity. Monitor blood pressure when beginning an antihypertensive drug and throughout titration, and periodically after desired hypertension high blood pressure symptoms is achieved. NON-PHARMACOLOGIC INTERVENTIONS: Advise all patients to stop smoking, shed extra high blood pressure symptoms in men pounds, restrict dietary unhealthy fat and salt intake, limit alcohol, and exercise appropriately. Avoid estrogen-containing oral contraceptives; a progestin-only pill might be preferable. Such change in lifestyle should be continued even when blood pressure level remains elevated and drug treatment methods are initiated. PHARMACOLOGIC INTERVENTIONS: See charts in this section. Doses of drugs should be individualized. Visit www.eMPR.com for an entire list of antihypertensive medications. ACCUPRIL Pfizer Rx ACE inhibitor. Quinapril (as HCI) 5mg10mg, 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: Once daily initially 10mg. Patients on diuretic: suspend diuretic for 2-3 days before beginning; resume diuretic if BP not controlled by quinapril alone. If diuretic should not be discontinued, or maybe creatinine clearance (CrCI) 30-60mL/min: initially 5mg daily. CrCI 1030mL/min: initially 2.5mg dally. Children: Not suggested. Contraindications: History of ACEI-associated or another 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 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 can cause hyperkalemia. May increase lithium levels. Antagonizes tetracycline. Potentiated by diuretics. Complications: Headache, cough, fatigue and dizziness GI upset, hyperkalemia, back pain,

tachycardia, dry mouth, somnolence, sweating, sinusitis. How supplied: Tabs-90 ACEON Solvay Rx ACE inhibitor. Perindopril http://www.vaughns-1-pagers.com/medicine/blood-pressure.htm erbumine4mg and 2mg, 8mg; scored tabs. Indications: Hypertension.

Adults: Or even on diuretic: initially 4mg once daily or in 2 divided doses. Titrate; max 16mg/day. Usual maintenance 4-8mg once dally. If on diuretic: If you can, 2-three days before you start therapy, suspend diuretic. If diuretic should not be discontinued (monitor closely): initially 2-4mg once daily or 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 suggested. Elderly: >65 yrs: usual max 8mg/day. Contraindications: Past of ACEI-associated or another angioedema. Pregnancy (Cat.D In 2nd and 3rd 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 could possibly have greater risk of angioedema than nonblack 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