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- Pharmacology For Atorvastatin + Ramipril
Atorvastatin + Ramipril Pharmacology
Atorvastatin + RamiprilAbout Atorvastatin + RamiprilN/AMechanism of Action of Atorvastatin + RamiprilN/APharmacokinets of Atorvastatin + RamiprilN/AOnset of Action for Atorvastatin + RamiprilN/ADuration of Action for Atorvastatin + RamiprilN/AHalf Life of Atorvastatin + RamiprilN/ASide Effects of Atorvastatin + RamiprilN/AContra-indications of Atorvastatin + Ramipril1.Active liver disease: cholestasis, hepatic encephalopathy, hepatitis, and jaundice
2.Unexplained elevations in AST or ALT levels
3.Renovascular disease, severe renal impairment
4.History of angioedema while on an ACE inhibitor
Special Precautions while taking Atorvastatin + RamiprilN/APregnancy Related InformationContra indicatedOld Age Related InformationN/ABreast Feeding Related InformationContra indicatedChildren Related InformationN/AIndications for Atorvastatin + RamiprilTreatment of patients with both essential hypertension and hypercholesterolemia.Interactions for Atorvastatin + RamiprilN/ATypical Dosage for Atorvastatin + RamiprilN/ASchedule of Atorvastatin + RamiprilN/AStorage Requirements for Atorvastatin + RamiprilN/AEffects of Missed Dosage of Atorvastatin + RamiprilN/AEffects of Overdose of Atorvastatin + RamiprilN/A
AtorvastatinAbout AtorvastatinHMG-CoA Reductase Inhibitor, statins, Antilipemic agent.Mechanism of Action of AtorvastatinIt is a more potent statin which competitively inhibits the conversion of 3-hydroxy-3-methyl glutaryl coenzyme A (HMG CoA) to mevalonate. The drug exerts it`s action by specific inhibition of enzyme; 3-hydroxy-3-methyl glutaryl coenzyme A reductase (HMG CoA reductase) and reduces cholesterol synthesis up to 50% at therapeutic doses. This results in compensatory increase in low density lipoprotein (LDL) receptor expression in liver which ultimately leads to increased receptor mediated uptake and catabolism of intermediate density lipoprotein(IDL) and low density lipoprotein (LDL). It causes dose dependent lowering of LDL cholesterol and reduces hepatic synthesis of very low density lipoprotein (VLDL) and lowers plasma triglyceride levels. It also increases high density lipoprotein (HDL) levels. It also exerts antioxidant property.Pharmacokinets of AtorvastatinAbsorption: Readily absorbed orally, Distribution: Widely distributed in a highly protein bound form, Metabolism: Metabolized in liver in to active metabolite, Excretion: Excreted mainly through bile.Onset of Action for AtorvastatinN/ADuration of Action for AtorvastatinN/AHalf Life of Atorvastatin18 to 24 hoursSide Effects of Atorvastatin1.Headache
13.Abnormal liver function tests
21.Upper respiratory tract infections
Contra-indications of Atorvastatin1.Hypersensitivity to the drug
2.Active liver diseases
3.Persistent elevation of serum transaminase levels
Special Precautions while taking Atorvastatin
1.Monitor hepatic function tests and lipid levels before and periodically during therapy and stop drug if there is marked elevation of creatinine phosphokinase level
2.History of liver diseases
4.In severe adverse effects and fever
Pregnancy Related InformationContraindicatedOld Age Related InformationMay be usedBreast Feeding Related InformationContraindicatedChildren Related InformationUse with caution
Below 9years: ContraindicatedIndications for Atorvastatin1.Hypercholesterolemia
Interactions for AtorvastatinN/ATypical Dosage for AtorvastatinOral:
Starts with 10mg once daily; Increased if required based on patients response.
Maximum dose: 80mg
Schedule of AtorvastatinHStorage Requirements for AtorvastatinStore at room temperature at a range of 15 to 25 degree C.Effects of Missed Dosage of AtorvastatinTake the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.Effects of Overdose of AtorvastatinProvide supportive care and symptomatic treatment.
RamiprilAbout RamiprilAngiotensin - converting enzyme inhibitor, Antihypertensive.Mechanism of Action of RamiprilIt is a prodrug and converted in to active Ramiprilat; which is an angiotensin converting enzyme inhibitor prevents the conversion of angiotensin-1 to angiotensin-2 and abolishes the pressor actions of angiotensin. It decreases aldosterone secretion, sodium and water retention, and total peripheral resistance, leads to fall in BP. The arterioles dilate and the compliance of larger arteries is increased. Both systolic and diastolic BP is lowered. The drug does not compromise renal, cerebral, and coronary blood flow. The drug also increases plasma kinin levels and potentiate the hypotensive action of exogenously administered bradykinin. It is used for treatment of systolic heart failure, because it improves symptoms, decrease mortality and reduce ventricular hypertrophy. It reduces both preload and after load and thus increasing cardiac out put in patients with heart failure.Pharmacokinets of RamiprilAbsorption: Absorbed orally up to 60%, Distribution: Widely distributed in the tissues, Metabolism: Metabolized in the body in to active metabolite, Ramiprilat. Excretion: Excreted mainly through urine and also excreted through faeces.Onset of Action for Ramipril1 to 2 hoursDuration of Action for Ramipril24 hoursHalf Life of Ramipril8 to 48 hoursSide Effects of Ramipril1.Cough
8.Swelling of lips, mouth, nose, and larynx
9.Fetopathic in later half of pregnancy
17.Acute renal failure is precipitated in renal artery stenosis
Contra-indications of Ramipril1.Hypersensitivity to the drug
2.Renal artery stenosis
4.Coarctation of aorta
Special Precautions while taking Ramipril1.Renal impairment
3.Use cautiously in patient at high risk of cardiogenic shock, severe heart failure etc
4.Anaesthesia and surgery
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationContraindicatedChildren Related InformationContraindicatedIndications for Ramipril1.Hypertension
Interactions for RamiprilAntacids: May decrease bioavailability of ramipril.
Phenothiazines: Pharmacologic effects enhanced by phenothiazines.
Allupurinol: Higher risk of hypersensitivity reactions.
Digoxin: Increases plasma digoxin levels.
Potassium preparations & Potassium sparing diuretics: Hyperkalaemia and increased risk of renal failure.
Lithium: Toxicity due to increased serum concentration of lithium. Typical Dosage for RamiprilStarts with 1.25mg once daily. Increases the dose to 2.5 to 5mg once daily; depending on patient`s response.
Maximum dose: 10mg once daily.
In CHF patients starts the dosage with 1.5mg once daily dosage and gradually increases at 2 to3 weeks` intervals to usual dosage.
Schedule of RamiprilHStorage Requirements for RamiprilStore at a temperature range of 15 to 30 degree C. in a well closed container and protect from moisture.
Effects of Missed Dosage of RamiprilTake the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.Effects of Overdose of RamiprilTreatment is supportive and symptomatic. To remove drug from the body perform induced emesis and gastric lavage. Administer activated charcoal to reduce absorption. In severe cases haemodialysis is considered if required. Treatment includes I.V. infusion of normal saline solution.
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