Lisinopril

Question 1

Alternate Names

Answer 1

Prinivil, Zestril, captopril, enalapril, ramipril, total of 10

Question 2

Cost

Answer 2

4-56% per month

Question 3

Drug Class

Answer 3

Pharma: ACE inhibitor
Therapeutic: Antihypertensive, treatment of CHF, preserving renal function, preserving LV function after MI, acute management of MI

Question 4

Pharmacodynamics

Answer 4

Inhibits conversion of AT 1 to AT 2 by ACE; diminishes both vasoconstriction and stimulation of aldosterone secretion by AT 2

Question 5

Pharmacokinetics

Answer 5

Well absorbed; onset 1 hr, peak 6 hr, duration 24 hr; once a day is fine; excreted primarily in urine as unchanged drug

Question 6

Toxicity

Answer 6

Orthostatic hypotension; use with caution in patients with impaired renal function, or renal artery stenosis; be careful in patients on diuretics, or those with aortic stenosis; angioedema, cough, acute renal failure

Question 7

Interactions

Answer 7

Additive effects with most other antihypertensives; NSAIDS may reduce ability to lower BP; hyperkalemia with KCL, others

Question 8

Special Considerations

Answer 8

Often discontinue diuretics prior to beginning use to reduce hypertension; category C/D in pregnancy, abnormal cartilage development

Question 9

Indications and Dose / Route

Answer 9

Begin 10 mg per day, titrate slowly upward to 40 mg per day max

Question 10

Monitor

Answer 10

BP, weight, edema, K, BUN, creatinine