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Category:
Description:
Indications:
-
Hypertension,
heart failure, left ventricular dysfunction after MI
-
Diabetic
nephropathy in Type 1 patients (proteinuria > 500mg/daily)
Contraindications:
Precautions:
-
Pregnancy
category C (1st trimester) and D (3rd trimester)
-
Dialysis
patients, hypovolemia, leukemia, scleroderma, lupus erythematosus
-
Blood
dyscrasias, thyroid disease, COPD, asthma, CHF, hyperkalemia
-
Potassium
sparing diruretics, cough, aortic stenosis, pediatric use
Adverse
Reactions (Side Effects):
-
CNS:
chills, fever
-
CV:
chest pain, hypotension, palpitations, postural hypotension,
tachycardia
-
GI:
loss of taste
-
GU:
acute reversible renal failure, dysuria, frequency, impotence,
nephrotic syndrome, oliguria, polyuria, proteinuria
-
HEME:
agranulocytosis, neutropenia
-
METAB:
hyperkalemia, hyponatremia
-
RESP:
angioedema, bronchospasm, cough, dyspnea
-
SKIN:
rash
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Dosage:
Administered
orally
-
Adult:
-
Hypertensive
crisis: PO 25mg, increasing every 2 hours until desired
response; do not exceed 450mg daily
-
Hypertension:
PO initial dose 12.5mg 2-3 times daily; may increase to 50mg 2-3
times daily at 1-2 week intervals; usual range 25-150mg 2-3 times
daily; max 450mg daily
-
Diabetic
nephropathy: PO 25mg 3 times daily
-
Congestive
heart failure: PO 12.5mg 2-3 times daily; may increase to 50mg
2-3 times daily; after 14 days, may increase to 150mg 3 times
daily if needed
-
Child:
Drug
Interactions:
-
Allopurinol:
increased risk of hypersensitivity reactions including Stevens-Johnson
syndrome, skin eruptions, fever, and arthralgias
-
NSAIDS:
inhibits the antihypertensive response to ACE inhibition
-
Lithium:
increased risk of lithium toxicity
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Source:
Operational Medicine 2001, Health
Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau
of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington,
D.C., 20372-5300
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