Lisinopril
LisinoprilPharmacological action
Inhibitor of the prolonged action. Breaks transformation of angiotensin I in biologically active angiotensin II which raises a tonus of peripheric vessels, and also promotes secretion of Aldosteronum by adrenals.
Because of gradual depression of a BP of a reflex tachycardia does not arise. Rate of a glomerular filtration at patients with an arterial hypertensia and normal renal function practically does not change.
BP depression becomes perceptible through 1 h after preparation reception, the maximum hypotensive effect is observed through 6 h.Lisinopril action proceeds during 24 h.
At patients with chronic heart failure Lisinopril, reduces an afterload by heart, enlarges shock and minute volume of heart without CARDIAC CONTRACTIONS RATE augmentation, raises tolerance to an exercise stress.
Besides, Lisinopril reduces a preload, promotes pressure decrease in a small circle of a circulation and in the right auricle, causes regress of a hypertrophy of a myocardium.
Indications
- An arterial hypertensia;
- A chronic heart failure.
Dosage regimen
It is necessary to accept a preparation of 1 time/sut irrespective of food intake.
At treatment of an arterial hypertensia initial Lisinopril dose makes 10 mg/days Further a dosage regimen correct in the course of treatment depending on clinical efficiency of a preparation. The average dose makes 20-40 mg/days
To patients with the arterial hypertensia, receiving diuretic preparations, it is necessary to stop their reception for 2-3 days prior to the beginning of Lisinopril reception. At impossibility of their Lisinopril cancellation prescribe in an initial dose of 2 mg/days Further a dose correct according to dynamics of change of a BP.
Side effect
From cardiovascular system: an orthostatic hypotension, a stethalgia.
From the alimentary system: a diarrhoeia, a nausea, vomiting, dyspepsia symptoms.
From party TSNS: a headache, giddiness, fast fatigability, drowsiness, a sleeplessness, depression.
From respiratory system: dry tussis.
Allergic reactions: feeling of fever, reddening of integuments, an itch; seldom - a Quincke's disease (including face edemas, tongue, a vocal cleft, a larynx, extremities).
The other: a hyperpotassemia; seldom - a joint pain and humeral muscles, visual acuity change, a vasculitis.
Lisinopril is usually well transferred.
Contraindications
- A Quincke's disease in the anamnesis;
- Pregnancy;
- A lactemia (thoracal feeding);
- A hypersensibility to a preparation.
Pregnancy and lactemia
Lisinopril is contraindicative to application at pregnancy and in a lactemia (thoracal feeding).
Preparation application in II and III trimester of pregnancy can lead to reduction of quantity of an amnionic liquid, an arterial hypotension and to disturbances of formation of bones of a skull of a foetus.
Special indicatings
At patients with an uncomplicated arterial hypertensia against Lisinopril application in 1.2 % of cases the arterial hypotension, in 0.1 % of cases - syncopes became perceptible. The probability of development of the specified phenomena raises at disturbances of vodno-electrolytic balance (including at application of diuretics), at the exhausted patients and the patients who are on a hemodialysis. At Lisinopril application for the given category of patients are necessary the careful medical control within the first 2 weeks of therapy and, at necessity, correction of Lisinopril dose and-or a diuretic.
With care it is necessary to apply a preparation at patients with an ischemic heart disease or diseases of vessels of a brain to avoid sharp depression of a BP at this category of patients.
The transient arterial hypotension is not contraindication to the further application of a preparation after BP stabilisation. At BP depression it is necessary to lower a dose or to stop Lisinopril reception or a diuretic.
With a chronic heart failure with a normal or low BP Lisinopril reception can cause the further depression of a BP in patients, however it is not the basis for a treatment suspension.
At carrying out of clinical tests hyperpotassemia development (concentration of a potassium in Serum more than 5.7 mekv/l) became perceptible approximately at 2.2 % of patients with an arterial hypertensia and at 4.8 % of patients with a heart failure. At joint Lisinopril application with the above-stated preparations the frequent control of concentration of a potassium in blood serum is necessary.
At the sudden termination of Lisinopril reception there is no fast or essential augmentation of a BP in comparison with its level prior to the beginning of preparation reception.
Efficiency and safety of Lisinopril application does not depend on age of the patient.
Use in pediatrics
Efficiency and safety of application of a preparation at children are not established.
Overdosage
Clinical data about Lisinopril overdosage at people are absent.
For mice and rats at peroral introduction LD50 of a preparation makes 20 g/kg of mass of a body.
Probable symptoms: an arterial hypotension.
Treatment: the patient should give horizontal position with the raised feet, if necessary i.v. driply enter a normal saline solution; spend a hemodialysis.
Conditions and periods of storage
The preparation should be stored at temperature not above 30 C. The Period of validity - 3 years.
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