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- Pharmacology For Losartan potassium + Ramipril + Hydrochlorothiazide
Losartan potassium + Ramipril + Hydrochlorothiazide Pharmacology
Losartan potassium + Ramipril + Hydrochlorothiazide
About Losartan potassium + Ramipril + HydrochlorothiazideN/AMechanism of Action of Losartan potassium + Ramipril + HydrochlorothiazideN/APharmacokinets of Losartan potassium + Ramipril + HydrochlorothiazideN/AOnset of Action for Losartan potassium + Ramipril + HydrochlorothiazideN/ADuration of Action for Losartan potassium + Ramipril + HydrochlorothiazideN/AHalf Life of Losartan potassium + Ramipril + HydrochlorothiazideN/ASide Effects of Losartan potassium + Ramipril + HydrochlorothiazideN/AContra-indications of Losartan potassium + Ramipril + HydrochlorothiazideN/ASpecial Precautions while taking Losartan potassium + Ramipril + HydrochlorothiazideN/APregnancy Related InformationN/AOld Age Related InformationN/ABreast Feeding Related InformationN/AChildren Related InformationN/AIndications for Losartan potassium + Ramipril + HydrochlorothiazideN/AInteractions for Losartan potassium + Ramipril + HydrochlorothiazideN/ATypical Dosage for Losartan potassium + Ramipril + HydrochlorothiazideN/ASchedule of Losartan potassium + Ramipril + HydrochlorothiazideN/AStorage Requirements for Losartan potassium + Ramipril + HydrochlorothiazideN/AEffects of Missed Dosage of Losartan potassium + Ramipril + HydrochlorothiazideN/AEffects of Overdose of Losartan potassium + Ramipril + HydrochlorothiazideN/ALosartan Potassium
About Losartan PotassiumAn angiotensin II receptor antagonist, Antihypertensive.Mechanism of Action of Losartan PotassiumIt is a competitive antagonist of angiotensin-2 at AT-1 receptor. It decreases peripheral resistance and lowers BP in hypertensive individuals. It blocks all overt actions of angiotensin-2 such as: - 1. Vasoconstriction, 2. Central & Peripheral sympathetic stimulus, 3. Release of aldosterone and adrenaline, 4. Salt and water reabsorption, 5. Central actions like thirst, vasopressin release, and growth promoting actions on heart and blood vessels.Pharmacokinets of Losartan PotassiumAbsorption: Well absorbed orally, but bioavailability is about 33% due to first pass metabolism.
Distribution: Distributed in to the body in a protein bound form, but there is no brain penetration.
Metabolism: Metabolized in the liver in to active carboxylic acid metabolite and other metabolites.
Excretion: Excreted through faeces and urine.
Onset of Action for Losartan Potassium1 hourDuration of Action for Losartan PotassiumN/AHalf Life of Losartan Potassium2 hours
Half life of active metabolite: 6 to 9 hours
Side Effects of Losartan Potassium1. Hypotension
2. Hyperkalemia
3. Headache
4. Breathlessness
5. Chest pain
6. Sore throat
7. Infections
8. Weakness
9. Dizziness
10. Elevated liver enzyme levels
11. Myalgia
12. Fetopathic
13. Precipitate renal failure in renal artery stenosis, and in insufficient renal blood flow
14. Rashes
15. Insomnia
16. Nightmares
Contra-indications of Losartan Potassium1. Hypersensitivity to the drugSpecial Precautions while taking Losartan Potassium1.Hepatic impairment
2.Renal impairment
3.Heart failure
4.Volume depleted individuals
5.Monitor serum potassium levels and avoid use along with potassium sparing diuretics
6. Avoid driving or operating heavy machinery during therapy
7. Avoid alcohol use during therapy
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationContraindicatedChildren Related InformationContraindicatedIndications for Losartan Potassium1. HypertensionInteractions for Losartan PotassiumDiuretics, other antihypertensives: Potentiate the hypotensive effect of losartan.
Potassium sparing diuretics, potassium suppliments: Risk of hyperkalaemia.
NSAIDs: May blunt hypotensive effect of losartan.
Cytochrome P450 inhibitors like ketoconazole: Increase in AUC of losartan by 18 % but has no effect on its active metabolite.
Phenobarbital: Results in 20% reduction in AUC of losartan and its active metabolite.Typical Dosage for Losartan Potassium25 to 50mg once daily. Gradually increases up to 100mg once daily or as two divided doses.Schedule of Losartan PotassiumHStorage Requirements for Losartan PotassiumStore at room temperature at a range of 15 to 30 degree C. protect from moisture and store in a tightly closed container.Effects of Missed Dosage of Losartan PotassiumTake the missed dose as soon as remember; if it is the time of next dose then skip the missed dose and take the regular dose.Effects of Overdose of Losartan PotassiumTreatment is supportive and symptomatic.Ramipril
About 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
2.Angioedema
3.Hypotension
4.Chest pain
5.Hyperkalemia
6.Rashes
7.Urticaria
8.Swelling of lips, mouth, nose, and larynx
9.Fetopathic in later half of pregnancy
10.Headache
11.Diarrhoea
12.Fatigue
13.Dizziness
14.Nausea
15.Neutropenia
16.Thrombocytopenia
17.Acute renal failure is precipitated in renal artery stenosis
Contra-indications of Ramipril1.Hypersensitivity to the drug
2.Renal artery stenosis
3.Aortic stenosis
4.Coarctation of aorta
Special Precautions while taking Ramipril1.Renal impairment
2.Hepatic 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
2.Heart failure
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.Hydrochlorothiazide
About HydrochlorothiazideThiazide derivatibve, Diuretic.Mechanism of Action of HydrochlorothiazideIt is thiazide diuretic which exerts its 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 has additional carbonic anhydrase inhibitory actions in proximal tubules. It increases natriuresis, kaliuresis and diuresis. It decreases Ca2+ excretion and increases Mg2+excretion. It also has minor carbonic anhydrase inhibitory action. It also causes direct arteriolar vasodilatation and decreases total peripheral resistance. The antihypertensive actions of the drug may be attributable to depletion of sodium and subsequent reduction in plasma volume and a decrease in peripheral resistance. 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.
Vertigo: Diuretics are used in vertigo in assumption that vertigo is due to endolymphatic hydrops. They reduce labyrinthine fluid pressure
Pharmacokinets of HydrochlorothiazideAbsorption: It is absorbed after oral administration.
Metabolism: It is not metabolized in the body.
Excretion: Excreted unchanged in urine.
Onset of Action for Hydrochlorothiazide1 to 3 hoursDuration of Action for Hydrochlorothiazide12 to 16 hoursHalf Life of Hydrochlorothiazide5 to 15 hoursSide Effects of Hydrochlorothiazide1. Dizziness
2. Blurred vision
3. Confusion
4. Tingling fingers
5. Dry mouth
6. Nausea
7. Diarrhoea
8. Constipation
9. Vomiting
10. Weakness
11. Hypokalaemia
12. Hyponatraemia
13. Hyperuricaemia
14. Elevated levels of glucose, calcium and lipids
15. Gastro intestinal disturbances
16. Polyuria
17. Electrolyte imbalance
18. Jaundice
19. Rashes
20. Photosensitivity
21. Fever
22. Itching
23. Myalgia
24. Muscle cramps
25. Arthralgia
26. Blood dyscrasias
27. Ototoxicity
Contra-indications of Hydrochlorothiazide1. Hyper uricaemia
2. Hyper calcaemia
3. Renal impairment
4. Hepatic impairment
5. Anuria
6. Hypersensitivity to the drug
7. Hyper sensitivity to sulfonamides
8. Fluid and electrolyte imbalance
Special Precautions while taking Hydrochlorothiazide1. Gout
2. Diabetes mellitus
3. Renal impairment
4. Hepatic impairment
5. Monitor and correct Fluid and electrolyte imbalance
6. Hyper parathyroidism
7. Cirrhosis
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationContraindicatedChildren Related InformationMay be usedIndications for Hydrochlorothiazide1. Hypertension
2. Oedema associated with heart failure
3. Oedema due to renal and hepatic diseases
4. Diabetes insipidus
5. Idiopathic hypercalciurea.
6. Vertigo
Interactions for HydrochlorothiazideCholestyramine & Colestipol: decrease absorption of hydrochlorothiazide.
Diazoxide: Additive action - may cause hyperglycemia, hyperuricaemia and hypotension.
Digitalis: Diuretics induced hypokalaemia may precipitate digitalis toxicity.
Lithium: Hydrochlorothiazide potentiates therapeutic and toxic effects by increasing its renal excretion.
Frusemide: Synergy leading to profound diuresis and greater than predicted electrolyte loss.
Non-depolarizing muscle relaxants: Diuretics induced hypokalaemia enhances efficacy.
Sulfonylureas: Efficacy decreased due to hydrochlorothiazide induced glucose intolerance.
Chlorpropamide: Hypokalaemia.
Propantheline: Bioavailability of hydrochlorothiazide increased.
Metoclopramide: Bioavailability of hydrochlorothiazide decreased.
NSAIDs: Natriuretic effect of hydrochlorothiazide decreased.
Typical Dosage for HydrochlorothiazideAdults:
Hypertension: 25mg once daily or in divided doses. Increased to 50mg if required; depending up on the patient`s response.
Children: 1mg/kg single daily dose.
Oedema:
Adults:
Starts with 25 to 50mg. Increased the dose until desired response is obtained.
Maximum dose: 200mg/day
Maintenance dosage: 25 to 100mg daily or on alternate days.
Children: 1mg/kg single daily dose or 1 to 3mg/kg/day in two divided doses
Schedule of HydrochlorothiazideGStorage Requirements for HydrochlorothiazideStore at room temperature in a well closed container and protected from light.Effects of Missed Dosage of HydrochlorothiazideTake 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 HydrochlorothiazideTreatment 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.Home Delivery for Losartan potassium + Ramipril + Hydrochlorothiazide in Your City
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