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- Pharmacology For Perindopril + Indapamide
Perindopril + Indapamide Pharmacology
Perindopril + IndapamideAbout Perindopril + IndapamideN/AMechanism of Action of Perindopril + IndapamideN/APharmacokinets of Perindopril + IndapamideN/AOnset of Action for Perindopril + IndapamideN/ADuration of Action for Perindopril + IndapamideN/AHalf Life of Perindopril + IndapamideN/ASide Effects of Perindopril + IndapamideN/AContra-indications of Perindopril + IndapamideN/ASpecial Precautions while taking Perindopril + IndapamideN/APregnancy Related InformationN/AOld Age Related InformationN/ABreast Feeding Related InformationN/AChildren Related InformationN/AIndications for Perindopril + IndapamideN/AInteractions for Perindopril + IndapamideN/ATypical Dosage for Perindopril + IndapamideN/ASchedule of Perindopril + IndapamideN/AStorage Requirements for Perindopril + IndapamideN/AEffects of Missed Dosage of Perindopril + IndapamideN/AEffects of Overdose of Perindopril + IndapamideN/A
PerindoprilAbout PerindoprilA long-acting Dicarboxylate-containing ACE inhibitor, Antihypertensive.Mechanism of Action of PerindoprilIt is a prodrug and converted in to active Perindoprilat; which is a long acting 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. The drug restores the reduced elastic properties of arteries and heart in hypertensive individuals. 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 PerindoprilAbsorption: Well absorbed orally, Distribution: It is distributed in to the body, Metabolism: Metabolized in the body in to active metabolite, Perindoprilat; and other inactive metabolites Excretion: Excreted mainly through urine.Onset of Action for Perindopril60minutesDuration of Action for Perindopril24 hourHalf Life of PerindoprilN/ASide Effects of Perindopril1.Cough
7.Swelling of lips, mouth, nose, and larynx
8.Fetopathic in later half of pregnancy
18.Decreased haemoglobin count
20.Elevated liver enzymes
21.Acute renal failure is precipitated in renal artery stenosis
Contra-indications of Perindopril1.Hypersensitivity to the drug
2.Renal artery stenosis
4.Coarctation of aorta
Special Precautions while taking Perindopril1.Renal impairment
3.Ischaemic heart disease
4.Severe heart failure
5.Collagen vascular diseases
8.Lower dosage is needed for elderly
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationContraindicatedChildren Related InformationContraindicatedIndications for Perindopril1.Hypertension
2.Congestive heart failure
Interactions for PerindoprilNitrates, Diuretics, Beta-blockers, Anti-depressants, Alcohol, Calcium channel blockers: Enhanced hypotensive effect.
Potassium sparing diuretics: Hyperkalaemia.
Sex hormones: Oestrogens and combined oral contraceptives antagonise hypotensive effect.Typical Dosage for PerindoprilStarts with 4mg; orally once daily. Increases the dose to 8mg once daily or in two divided doses; after one month of therapy depending on patient`s response.
Maximum dose: 16mg/day
In CHF patients starts the dosage with 2mg once daily dosage and gradually increases at 1 to2 weeks` intervals to 4mg or further increase in dose depends up on patient`s response.
Schedule of PerindoprilHStorage Requirements for PerindoprilStore at a temperature range of 15 to 30 degree C. in a well closed container and protect from light and moisture.
Effects of Missed Dosage of PerindoprilN/AEffects of Overdose of PerindoprilTreatment 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 to treat hypotension. Treat dehydration and maintain electrolyte balance.
IndapamideAbout IndapamideThiazide-related(a non-thiazide sulphonamide) drug, Diuretic, Antihypertensive.Mechanism of Action of IndapamideIt exerts thiazides like diuretic action by acting at site-3(central dilating segment of early distal tubule). It binds to Na+Cl- symporter and inhibits Na+Cl- symport at the luminal membrane. It increases natriuresis, kaliuresis and diuresis. It decreases Ca2+ excretion and increases Mg2+excretion.
It causes vasodilatation by Ca channel blockade. It decreases total peripheral resistance and exerts anti hypertensive action. Decrease in peripheral resistance is due to either the loss of sodium from the arteriolar wall or a direct action on the vascular bed. It is an effective drug in edema associated with congestive heart failure.
Pharmacokinets of IndapamideAbsorption: It is compleately absorbed orally.
Distribution: Widely distributed
Metabolism: Extensively metabolized inside the body, and a small portion reaches tubular fluid.
Excretion: Excreted mainly through urine and rest is excreted through faeces.
Onset of Action for Indapamide1 to 2 hoursDuration of Action for Indapamide24 to 36 hoursHalf Life of IndapamideN/ASide Effects of Indapamide1. Dizziness
3. Orthostatic hypotension
4. Back pain
14. Muscle cramps
15. Peripheral edema
21. Hyper urecaemia
22. Elevated levels of glucose calcium and lipids
23. Gastro intestinal disturbances
25. Visual impairment
26. Electrolyte imbalance
Contra-indications of Indapamide1. Hepatic impairment.
2. Hypersensitivity to the drug
3. Hypersensitivity to Sulfonamides
4. Anuric renal failure
5. Cerebro vascular accidents
Special Precautions while taking Indapamide1. Renal impairment
2. Progressive Liver diseases
3. Hyper urecaemia and Gout
4. Diabetes mellitus
5. Fluid and electrolyte imbalance
7. Hyper calcaemia
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationContraindicatedChildren Related InformationContraindicatedIndications for Indapamide1. Hypertension
Interactions for IndapamideDiazoxide: Synergistic action - may cause hyperglycemia, hyperuricaemia and hypotension.
Digitalis: Diuretic induced hypokalaemia may precipitate digitalis toxicity.
Frusemide: Synergy leading to profound diuresis and greater than predicted electroyte loss.
Sulfonylureas: Hypoglycaemic effects enhanced.
Propantheline: Bioavailability of indapamide increased.
Metoclopramide: Bioavailability of indapamide decreased.
NSAID`s: Natriuretic effect of indapamide decreased. Typical Dosage for IndapamideHyper tension: 1.25mg single daily dose. Increased to 2.5mg if required after 4 weeks.
Maximum dose: 5mg/day
Edema: 2.5mg single daily dose. Increased to 5mg if required after 1 week.
Schedule of IndapamideGStorage Requirements for IndapamideStore at a cool dry place; and at a temperature below 30 degree C. in a well closed container. Keep out of reach of children.Effects of Missed Dosage of IndapamideTake 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 Indapamide Treatment is supportive and symptomatic. Remove drug from the body by induced emesis and gastric lavage. Monitor and assist respiratory, cardiovascular, and renal function as indicated. Monitor and support fluid and electrolyte balance.
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