Pharm Ch34: Lisinopril (Prinivil, Zestril)

THERAPEUTIC
antihypertensive

PHARMACOLOGIC
ACE inhibitor

TREATS
HF, HTN and acute MI
decrease BP, decrease H2O, decrease Na, decrease BV,
decrease vascular resistance, decrease cardiac workload
(HTN decrease PR & increase HF, CO,decrease BP and Heart size)

MECHANISM OF ACTION
binds to and inhibits the action of ACE
Prevents the conversion of Angio I to Angio II leads
to decrease vasopressor activity & decrease aldosterone secretion

ROUTE
PO

METABOLISM
Not metabolized

EXCRETION
Renal

ADVERSE EFFECTS
cough, headache, dizziness, orthostatic hypotension
nausa, vomiting, H/A, rash, fatigue
serious – hepatotoxicity, angioedema,
hyperklemia, agranulocystosis

BLACK BOX
Fetal injury & death can occur when taken pregnant
acts directly on the renin-angiotensin system can
cause injury and death to the developing fetus

CONTRAINDICATIONS & PRECAUTIONS
Hyperkalimia, history of angioedema, serious renal impairment, pregnant

DRUG INTERACTIONS
NSAIDs – decrease antihypertensive drugs
increase worsen renal impairment – lisinopril +NSAIDs
Not w/antihypertensive & ACE inhibitors = synergistic hypotensive action
K+-sparing diurentics/K+ supplements may cause hyperkalemia
Li+-may increase effect & cause Li+ toxicity

OVERDOSE TX
tx hypotension w/ vasopressors
normal saline or hemodialysis

NURSING RESP / PT TEACHING
monitor elderly potassium level – hyperkalemia
report signs/symptoms of hypotension or persistant cough
report angioedema of face, lips, throat, or intestines
Avoid NA+ substitues w/K+CL
monitor BP for adverse effects – toxicity
monitor liver and renal function

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Hydroxyurea Hemoglobin of 4.2 indicates toxicity Platelets of 75,000 indicates toxicity Neutrophils of 1,400 indicates toxicity Used to treat sickle cell anemia Dopamine Given for cardiogenic shock Increased BP indicates effectiveness WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY …

Lisinopril indications Hypertension; adjunct treatment for heart failure (diuretics and cardiac glycosides); hemodynamically stable patients within 24 hours of acute MI to improve survival Lisinopril action causes decreased production of angiotension 2 and suppression of the renin-angiotensin-aldosterone system. WE WILL …

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amiodarone (Cordarone)/potassium channel blocker (antidysrhythmic) Treats: dysrythmias adverse effects: slow the heart rate resulting in bradycardia and hypotension, worsen dysrythmia monitoring: for dsyrthmias, older adults with heart failure for cardiac cardiac effects teaching: causes sun sensitivity, corneal deposits, visual disturbances, …

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