Drug of the Day: Lisinopril

Question 1

What is the trade name for lisinopril?

Answer 1

Zestril or Prinivil

Question 2

What is the drug class for lisinopril?

Answer 2

ACEI (angiotensin converting enzyme inhibitor)

Question 3

What is the primary indication for lisinopril?

Answer 3

hypertension

(appropriate for first line of management)

Question 4

What are the 2 mechanism of actions for lisinopril?

Answer 4

1. blocks conversion of angiotensin I to angiotensin II
   
   • (a potent vasoconstrictor)
2. lowers blood pressure

Question 5

The primary indication for lisinopril is hypertension, but 2 other indications include?

Answer 5

1. heart failure
2. acute myocardial infarction

Question 6

What is the more frequent key adverse effect of taking lisinopril is?

Answer 6

cough

A dry, non-productive cough will disappear when the drug is discontinued

Question 7

What is a rare incidence in the key adverse effects of taking lisinopril?

Answer 7

angioedema: swelling of extremities, face, lips, glottis or larynx

can be life threatening and must seek medical attention

(you cannot breath!)

Question 8

What are the 2 monitoring parameters when taking lisinopril?

Answer 8

1. blood pressure
2. serum potassium
   
   • want to make sure serum potassium lvl do not go up too much (for some people)

Question 9

What are the 3 key patient counseling points for taking lisinopril?

Answer 9

1. take at the same time each day (to get a continuous effect)
2. if you miss a dose, do NOT double up
3. avoid using salt substitutes (that contain potassium)
   
   1. example: Mrs Dash is a potassium salt.

Question 10

Is it necessary to adjust the dosing of lisinopril for patients with renal insuffiency?

Answer 10

YES

Question 11

What is the initial dosing for lisinopril?

Answer 11

5-10 mg

(dose on a once a day schedule)

Question 12

The initial dose for lisinopril is 5-10 mg once a day. When should a patient titrate up?

Answer 12

Titrate up to 20-40 mg per day when based on a clinial response