ANTIHYPERTENSIVE DRUGS - ZNF - Corrected ZNF
70 important questions on ANTIHYPERTENSIVE DRUGS - ZNF - Corrected ZNF
What are the indications for Magnesium Sulphate?
Indications for Magnesium Sulphate include:
- Pre-eclampsia
- Eclampsia
- For administration, side effects, contraindications, and cautions, see myocardial relaxants.
What is the initial dosage for neonates with pulmonary artery hypertension?
- Initially 250–500 mcg/kg every 4–8 hours
- Adjust according to response
- Start with lower dose and frequency
- Maximum 30 mg per day
What are the precautions for Sacubitril + Valsartan?
Precautions for Sacubitril + Valsartan include:
- Tablet containing 24 mg + 26 mg, 49 mg + 51 mg of Sacubitril-Valsartan.
- Symptomatic chronic heart failure with reduced ejection fraction.
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What is the administration method for adults with resistant hypertension using oral medication?
- Resistant hypertension (adjunct), oral
- Neonate: 250 to 500 mcg/kg every 8 to 12 hours, increase if necessary to a maximum of 2 to 3 mg/kg every 8 hours.
- 1 month–11 years: 7.5 mg/kg (maximum 200 mg) daily.
- 12 years and over: Use adult dose.
What are the contraindications listed for the medication?
- Hereditary degenerative retinal disorder
- History of non-arteritic anterior ischemic optic neuropathy
- Recent history of MI
- Recent history of stroke
- Sickle-cell anemia
What should be considered for children regarding Sacubitril + Valsartan?
Safety and efficacy of Sacubitril + Valsartan in children and adolescents below 18 years have not been established. No data are available.
What are the indications for the medication used for hypertension and prevention of cardiovascular events?
- Indications: Hypertension, Prevention of cardiovascular events in patients with established atherosclerotic cardiovascular disease or type 2 diabetes mellitus with target-organ damage.
What are the contraindications for the use of Bosentan?
- Contraindications: Pregnancy, hypersensitivity, concomitant cyclosporine or glyburide use, active liver failure or decompensated cirrhosis.
What are the side effects of the medication?
- Asthenia, constipation, depression
- Diarrhea, dizziness, drowsiness
- Dry mouth, dyspnoea, headache
- Nasal congestion, nausea, nervousness
- Oedema, palpitations, postural hypotension
- Sexual dysfunction, skin reactions
What are the side effects of Sacubitril + Valsartan?
Side effects of Sacubitril + Valsartan include:
- Anaemia
- Asthenia
- Cough
- Diarrhoea
- Dizziness
- Hyperkalaemia
- Hypotension
- Renal impairment
- Syncope
- Vertigo
What are the side effects and cautions associated with ACE inhibitors?
- Side effects: Hypotension, dizziness, dry cough, voice changes, throat discomfort, fatigue, headache, gastrointestinal disturbances, renal impairment, hypersensitivity reactions, blood disorders.
- Caution: May cause profound hypotension at induction, monitor renal function before and during treatment, reduce dose in renal impairment, breastfeeding. Monitor for possible hyperkalemia.
How is the medication for hypertension administered to adults?
- Administration: Adult
- Hypertension: oral. Initially 20–40 mg once daily for at least 4 weeks, increased if necessary up to 80 mg once daily.
- Prevention of cardiovascular events: oral. 80 mg once daily.
How should Sildenafil be administered for pulmonary arterial hypertension in adults?
- Administration: Adult
- Pulmonary arterial hypertension, oral: 25mg 3 times a day
What is the initial dosage for children aged 1 month–11 years with hypertension?
- Initially 10–15 mcg/kg 2–4 times a day
- Initial dose at bedtime
- Increased to 500 mcg/kg daily in divided doses
- Maximum 20 mg per day
What are the contraindications for Sacubitril + Valsartan?
Contraindications for Sacubitril + Valsartan include:
- Concurrent use with ACEI
- History of angioedema
- Concomitant use with aliskiren in patients with diabetes
- Severe hepatic impairment
What is the presentation of Enalapril?
Tablet (scored), containing 5 mg, 10 mg, 20 mg of Enalapril as hydrogen maleate.
What are the contraindications for ACE inhibitors?
- Contraindications: Hypersensitivity to ACE inhibitors, aortic stenosis, or left ventricle outflow tract obstruction, pregnancy, porphyria.
What are the indications for Prazosin?
- Hypertension secondary to pheochromocytoma
- Congestive heart failure (rarely used)
- Benign prostatic hyperplasia
What is the recommendation for the use of this medication in children?
- Children: No or insufficient experience in children and adolescents, therefore its use is not recommended.
What are the side effects associated with the medication described for resistant hypertension?
- Side effects: Tachycardia, nausea and vomiting, fluid retention, headache, systemic lupus erythematosus like syndrome after prolonged treatment with over 100mg daily.
What are beta-adrenoceptor blocking medicines used for?
Beta-adrenoceptor blocking medicines (beta-blockers) block beta-adrenoceptors in the heart, peripheral vasculature, bronchi, pancreas, and liver. They are used for their anti-arrhythmic properties.
What is the initial dosage for children with oedema?
- Initially 1–3 mg/kg daily in 1–2 divided doses.
What are the indications for Enalapril?
Hypertension, heart failure, and prevention of symptomatic heart failure in patients with asymptomatic left ventricular dysfunction.
What are the side effects of the medication?
- Side effects: See Losartan above.
Describe the presentation and indications for Lisinopril.
- Presentation: Tablet 2.5mg, 10mg, 20mg containing lisinopril.
- Indications: Hypertension, heart failure, diabetic nephropathy, prophylaxis after myocardial infarction.
What is the recommended dosage adjustment for Bosentan in children under 12 years of age?
- Children:
- Below 12 years of age: Dose is based on body weight and must be determined by a specialist.
What are the precautions for using Prazosin in elderly patients?
- Initiate with the lowest possible dose
- Caution with cataract surgery (risk of intraoperative floppy iris syndrome)
- Avoid in elderly due to hypotension
What is the intrinsic sympathomimetic activity (ISA) of beta-blockers?
Intrinsic sympathomimetic activity (ISA) of beta-blockers suppresses the capacity of beta-blockers to stimulate as well as to block adrenoceptor.
What are the indications for Frusemide?
Indications for Frusemide include:
- Oedema
- Oliguria due to renal failure
What are the side effects of Eplerenone?
- Hyperkalaemia, hyponatraemia, hyperchloremic acidosis, dehydration, transient increase in blood urea nitrogen, dizziness, gynecomastia, menstrual irregularities, impotence, hirsutism, hepatotoxicity.
How is Enalapril administered to adults for hypertension?
Initially 5 mg once daily, lower if used with a diuretic or in renal impairment; increase if necessary, usual maintenance dose 20 mg once daily; maximum 40 mg once daily.
What is the administration guideline for Lisinopril in hypertension?
- Administration: Initially 2.5mg daily, usual maintenance dose 10-20mg daily; max 40mg daily.
What are the contraindications for the medication?
- Contraindications: Hypersensitivity to the active substance or any of the excipients, in pregnancy, Biliary obstructive disorders, cholestasis, Severe hepatic impairment.
What should be noted about beta-blockers and heart conditions?
Beta-blockers slow the heart and can depress myocardial contractility; they are contraindicated in asthma and severe heart failure.
How is Frusemide administered for oedema in adults?
For oedema, Frusemide is administered orally, initially 40mg in the morning. Maintenance is 20mg daily or 40mg on alternate days, increased in resistant oedema to 80mg daily.
What are the contraindications for Eplerenone?
- Hyperkalaemia, hyponatraemia, moderate renal impairment, Addison disease, coadministration with Eplerenone.
What is the initial dose of Enalapril for children aged 1 month–17 years with hypertension?
Initially 100 mcg/kg once daily, monitor blood pressure carefully for 1–2 weeks, then increase if necessary to 1 mg/kg daily in 1–2 divided doses.
What cautions should be considered with the medication?
- Cautions: Electrolyte imbalance, Aortic and mitral valve stenosis, obstructive hypertrophic cardiomyopathy.
What are the side effects and contraindications for Losartan?
- Side effects: Hypoglycemia, dizziness, vertigo, hyperkalemia, hypotension, dyspnoea, cough, liver disorder, hypersensitivity, depression, malaise, urinary tract infection, renal impairment.
- Contraindications: Hypersensitivity to the active substance or to any of the excipients, in pregnancy. Severe hepatic impairment, electrolyte imbalance.
How should the drug dosage be managed according to the text?
Use the drug from one group to the maximum dosage before adding another one unless side effects are intolerable. The added drug must be from another group, preferably in a fixed dose combination to reduce pill burden.
What are the side effects of Torasemide?
Side effects of Torasemide include:
- Excessive urination
- Headache
- Electrolyte imbalance
- Dizziness
- Constipation
- Nausea
- Dyspepsia
- Asthenia
How should Eplerenone be administered in chronic heart failure?
- Start with 25 mg daily, then increased to 50 mg daily, increased within 4 weeks of initial treatment.
What are some side effects of Enalapril?
Dizziness, headache, nausea, hypotension, dry cough, fatigue, asthenia, muscle cramps, rash, renal impairment, GI disturbance, pancreatitis, liver damage.
What are the indications and presentation for Telmisartan?
- Presentation: Tablet containing 40 mg, 80 mg of Telmisartan.
- Indications: Hypertension, chronic heart failure, diabetic nephropathy in type 2 diabetes.
What is the presentation and indication of Methyldopa?
- Presentation: Tablet containing 250mg and 500mg of Methyldopa.
- Indications: Hypertensive disorders in pregnancy.
What are the contraindications for Torasemide?
Contraindications for Torasemide include:
- Anuria
- Hepatic coma
- Hypersensitivity
What are the cautions for using Eplerenone?
- Monitor blood urea nitrogen and plasma electrolytes, the elderly, diabetes mellitus, porphyria, monitor high doses.
What are the contraindications for Enalapril?
Hypersensitivity to ACEIs (including angioedema), renovascular disease, pregnancy.
How is Methyldopa administered to adults?
- Administration: Adult: oral. Initially 250 mg 2–3 times daily, gradually increased at intervals of 2 or more days, if necessary, maximum 3 g daily.
Describe thiazide diuretics and their use.
Thiazides act at the beginning of the distal convoluted tubule and are moderately potent diuretics. Small doses of thiazides in combination with other antihypertensives are used in hypertension.
What is the presentation of Spironolactone?
Presentation of Spironolactone includes:
- Tablet containing 25mg, 50mg, and 100mg
- Oral suspension containing 5mg/ml
What is the presentation of Amiloride with Hydrochlorothiazide?
- Tablet containing 5mg Amiloride hydrochloride and 50mg Hydrochlorothiazide.
What precautions should be taken with Enalapril?
Cautious use with diuretics, hypotension with first dose, monitor in patients on diuretics, low-sodium diet, or dialysis; avoid in severe aortic stenosis, history of angioedema.
What are the contraindications for Methyldopa?
- Contraindications: depression, active liver disease, phaeochromocytoma, porphyria.
What is the presentation and indication of Hydrochlorothiazide?
Presentation: Tablet containing 25mg, 50mg Hydrochlorothiazide. Indications: Oedema, hypertension, heart failure, Nephrogenic diabetes insipidus.
How is Spironolactone administered for oedema in adults?
Spironolactone for oedema in adults is administered orally, 100-200 mg daily, increased if necessary to 400 mg daily in resistant oedema; maintenance dose, 25–200 mg daily.
What are the indications for Mannitol?
- Fluid retention, cerebral oedema, induction of forced diuresis.
What is the presentation of Captopril?
Tablet containing 12.5 mg, 25 mg, 50 mg; captopril.
What are the cautions associated with Methyldopa?
- Cautions: blood counts and liver-function tests advised, history of depression, positive direct Coomb test in up to 20% of patients (affects blood crossmatching), interference with laboratory tests.
What are the side effects and contraindications of Hydrochlorothiazide?
Side effects: Hypokalaemia, hypercalcaemia, and other electrolyte imbalances. Contraindications: Severe renal and hepatic impairment, hypercalcaemia.
What are the cautions for using Torasemide?
Cautions for using Torasemide include:
- Diabetes mellitus
- Electrolyte imbalance
- Gout
- Hyperlipidemia
- Cirrhosis
What are the side effects of Mannitol?
- Chills, fever, fluid depletion, hypotension.
What are the indications for Captopril?
Alone or in combination with diuretics in essential hypertension, adjunct in heart failure.
What is the presentation and indication of Hydralazine?
- Presentation: Tablet containing 25mg, 50mg Hydralazine hydrochloride. An injection containing 20mg/2ml Hydralazine hydrochloride.
- Indications: Adjunct (orally) to other antihypertensives like beta-blockers, nitrates, in the treatment of moderate to severe hypertension.
What is the administration guideline for Hydrochlorothiazide in adults?
Administration: Adult, oedema: initially 12.5 – 100mg daily, maintenance 25 – 50mg on alternate days. Hypertension: 25mg daily which can be increased to 100mg daily if necessary.
What are the contraindications for Mannitol?
- Dehydration, congestive heart failure.
How is Captopril administered for hypertension?
Used alone, initially 12.5 mg twice daily; if used with a diuretic, 6.25 mg twice daily; usual maintenance 25 mg twice daily, maximum 50 mg 2–3 times daily.
What caution should be taken with Hydrochlorothiazide?
Caution: Avoid in diabetes and gout, hypercalcaemia.
What is the presentation and indication of Metalozone?
Presentation: Tablet containing 5mg Metalozone. Indications: Oedema, Hypertension.
What is the administration guideline for Metalozone?
Administration: Oedema, 5 – 10mg in the morning daily.
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