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🤔🤨😤 Pharmacologic class: Angiotensin-converting enzyme (ACE) inhibitor
🤔🤨😤 Therapeutic class: Antihypertensive
🤔🤨😤 Pregnancy risk category C (first trimester), D (second and third trimesters)
🤔🤨😤 Prevents conversion of angiotensin I to the vasoconstrictor angiotensin II, thereby reducing sodium and water retention and enhancing blood flow in circulatory system
🤔🤨😤 Tablets: 10 mg, 20 mg, 40 mg
Indications and dosages
🤔🤨😤 ➣ Hypertension
🤔🤨😤 Adults: 10 mg P.O. daily. May increase as required up to 80 mg/day; typical range is 20 to 40 mg P.O. daily.
🤔🤨😤 ➣ Heart failure
🤔🤨😤 Adults: 10 mg P.O. daily. May increase over several weeks up to 40 mg/day; typical range is 20 to 40 mg/day.
🤔🤨😤 • Renal impairment
🤔🤨😤 • Adjunct in myocardial infarction
🤔🤨😤 • Nephropathy
🤔🤨😤 • Hypersensitivity to drug or other ACE inhibitors
🤔🤨😤 • Angioedema (hereditary or idiopathic)
🤔🤨😤 • Pregnancy
🤔🤨😤 Use cautiously in:
🤔🤨😤 • aortic stenosis, cardiomyopathy, cerebrovascular or cardiac insufficiency, renal or hepatic impairment, hyponatremia, hypovolemia
🤔🤨😤 • black patients with hypertension
🤔🤨😤 • patients receiving diuretics concurrently
🤔🤨😤 • elderly patients
🤔🤨😤 • breastfeeding patients (safety not established)
🤔🤨😤 • children (safety not established).
🤔🤨😤 • Don't administer within 2 hours of antacids.
🤔🤨😤 • Give with or without food, but avoid giving with high-potassium foods or potassium supplements.
🤔🤨😤 CNS: dizziness, drowsiness, fatigue, headache, insomnia, weakness, vertigo
🤔🤨😤 CV: hypotension, angina pectoris, tachycardia
🤔🤨😤 EENT: sinusitis
🤔🤨😤 GI: nausea, vomiting, diarrhea, anorexia
🤔🤨😤 GU: proteinuria, erectile dysfunction, decreased libido, renal failure
🤔🤨😤 Hematologic: agranulocytosis, bone marrow depression
🤔🤨😤 Metabolic: hyperkalemia
🤔🤨😤 Respiratory: cough, bronchitis, dyspnea, asthma, eosinophilic pneumonitis
🤔🤨😤 Skin: rash, angioedema
🤔🤨😤 Other: altered taste, fever, hypersensitivity reactions including anaphylaxis
🤔🤨😤 Drug-drug.Allopurinol: increased risk of hypersensitivity reaction
🤔🤨😤 Antacids: decreased fosinopril absorption
🤔🤨😤 Antihypertensives, diuretics, general anesthetics, nitrates, phenothiazines: additive hypotension
🤔🤨😤 Cyclosporine, indomethacin, potassium-sparing diuretics, potassium supplements: hyperkalemia
🤔🤨😤 Digoxin, lithium: increased blood levels of these drugs, greater risk of toxicity
🤔🤨😤 Indomethacin: decreased hypotensive effects
🤔🤨😤 Drug-diagnostic tests.Alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, bilirubin, blood urea nitrogen, creatinine, potassium: increased levels
🤔🤨😤 Antinuclear antibody titer: false-positive result
🤔🤨😤 Sodium: decreased level
🤔🤨😤 Drug-food.Salt substitutes containing potassium: hyperkalemia
🤔🤨😤 Drug-herbs.Capsaicin: increased incidence of cough
🤔🤨😤 Drug-behaviors.Acute alcohol ingestion: additive hypotension
🤔🤨😤 • Monitor cardiovascular, respiratory, and neurologic status.
🤔🤨😤 • Monitor CBC and liver and kidney function tests.
🤔🤨😤 • Measure blood pressure to assess drug efficacy and detect hypotension.
🤔🤨😤 • Assess patient's potassium intake; monitor serum potassium level.
🤔🤨😤 ☞ Monitor for signs and symptoms of angioedema and anaphylaxis. If these occur, withdraw drug and contact prescriber immediately.
🤔🤨😤 ☞ Instruct patient to immediately report rash or difficulty breathing.
🤔🤨😤 • Tell patient to report dizziness, fainting, bleeding tendency, change in urination pattern, swelling, or persistent cough.
🤔🤨😤 • Encourage patient to drink enough fluids to stay well hydrated.
🤔🤨😤 • Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.
🤔🤨😤 • Instruct female patient to notify prescriber if she suspects she is pregnant.
🤔🤨😤 • Tell patient that he will undergo regular blood testing during therapy.
🤔🤨😤 • As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, foods, herbs, and behaviors mentioned above.