Trade Name: Prinivil, Zestril
Therapeutic Class: angiotensin-converting enzyme (ACE) inhibitor
Mode Of Action: selectively suppresses rennin-angiotension-aldosterone system, inhibits angiotension-converting enzyme (ACE) and as a result prevents conversion of angiotension I to angiotemsion II (Gorenchtein, 2018).
Indications: hypertension, heart failure and reduction in mortality rate in acute myocardial infarction.
Route And Dosage For Adults: Initial dose: 10 mg oral once a day; Maintenance dose: 20 to 40 mg, oral, once a day, Maximum dose: 80 mg orally once a day
Cautions And Contraindications: caution in renal impairment, volume depletion, hypotension, elderly patients, aortic stenosis, hypertrophic cardiomyopathy; contraindicated in patients who are hypertensive to this drug, patient with history of angioedema, previous treatment with angiotension converting enzyme inhibitor, history of idiopathic or hereditary angioderma
Adverse Effects: dizziness, headache, hypotension, cough, chest pain, renal impairment, hyperkalemia, liver dysfunction, angioedema, rarely blood dyscracias
Nursing Implications: prior to administration: history of allergy to this drug, monitoring of vital signs like BP, pulse, skin colour, renal function and liver evaluation;
During and after administration: begin drug use within 24 hours of episode of acute MI, close patient monitoring;
Teaching points: the drug should be taken once a day, be careful with conditions like dehydration, vomiting as it may cause drop in BP, prompt reporting in cases of fever, sore throat, swelling or irregular heartbeat (Balling, Erstad & Weibel, 2015)
Balling, L., Erstad, B. L., & Weibel, K. (2015). Impact of a transition-of-care pharmacist during hospital discharge. Journal of the American Pharmacists Association, 55(4), 443-448.
Gorenchtein, M. (2018). Lisinopril/sitagliptin interaction. Reactions, 1686, 232-27.