Prinivil Flashcards

Prinivil Overview

• Generic name: Lisinopril
• Class: Antihypertensive medication

Dosage Forms

• Available as tablets in dosages: 2.5 mg, 5 mg, 10 mg, 20 mg, 30 mg, 40 mg

Indications

• Primarily used for hypertension
• Additionally indicated for renal impairment
• Management of congestive heart failure (CHF)
• Treatment of hemodynamically stable patients post-acute myocardial infarction within 24 hours

Dosing Information

• Normal starting dose: 20-40 mg per day in a single daily dose
• Initial dosing for hypertension: 10 mg once daily, with adjustments based on blood pressure response
• For patients with renal impairment: dose of 10 mg after 48 hours, >10 mg once daily for 6 weeks; start with 2.5 mg if low blood pressure is present

Mechanism of Action

• Suppresses the renin-angiotensin-aldosterone system
• As an ACE inhibitor, reduces the synthesis of angiotensin II, a potent vasoconstrictor
• Decreased angiotensin II leads to lower aldosterone release, resulting in reduced sodium and water reabsorption and decreased plasma volume
• Degrades bradykinin, which is a vasodilator

Pharmacokinetics

• Peak serum levels achieved in about 7 hours
• Half-life of the medication is approximately 12 hours
• Not metabolized; primarily excreted through urine

Drug Interactions

• Effect decreased with indomethacin; may increase cough with capsaicin
• Allopurinol raises risk of hypersensitivity reactions
• Decreases lithium elimination and may cause potassium-related issues such as hyperkalemia
• Can potentiate effects of oral antidiabetics or insulin

Contraindications and Precautions

• Contraindicated in patients with a history of angioedema related to ACE inhibitors
• Caution required in patients with renal impairment and those on potassium-sparing drugs
• Risk of hypoglycemia in patients using oral antidiabetics or insulin
• Pregnancy category D: Avoid use during pregnancy due to risks
• Rare complications include cholestatic jaundice or hepatitis

Adverse Effects

• Common side effects: dizziness, headache, fatigue, cough, diarrhea

Patient Consultation Points

• Can be taken with or without food
• Do not stop the medication without consulting a physician
• Avoid over-the-counter cough, cold, or allergy medications
• Refrain from salt substitutes that contain potassium
• Store in a cool, dry location
• If a dose is missed, take it as soon as possible unless close to the next dose; do not double dose
• Contact a physician if side effects persist or if swelling occurs