Lisinopril
What category class is Lisinopril
ACE inhibitor
What category class is theophylline
Methylxanthine
Common Trade Name
Tylenol
category class
Herbal Supplement
Category Class
Beta Blocker
What does lisinopril do
Blocks the conversion of angiotensin 1 to angiotensin 2
What is it used for
COPD and Asthma
Longterm use risk or high dose risk
hepatotoxicity
interactions
antidepressants and anticoagulants
What does metoprolol do
Lower heart rate, lower contractility, lower BP, lower myocardial oxygen demand
Why does lisinopril cause a cough
Blocks the enzyme responsible for breaking down bradykinin causing it to build up in the lungs and creating irritation causing cough
Mechanism of action
relax bronchial smooth muscle for bronchodilation and reducing airway inflammation through enzyme inhibition and receptor antagonism
Signs of toxicity
nausea, vomiting, RUQ pain, elevated LFT's
decreases effectiveness of what
oral contraceptives
why does metoprolol mask hypoglycemia
it blocks the actions of adrenaline and norepinephrine on the sympathetic nervous system
Why can potassium increase
Angiotensin 2 stimulates aldosterone. Aldosterone causes kidney to retain sodium and excrete potassium.
Potential adverse effects
insomnia, jitteriness, tachycardia
Antidote
N-Acetlycysteine (NAC)
Uses
Mild depression, anxiety symptoms
what should we check before giving metoprolol and why
Check HR and BP, because the medication lowers both. Can cause severe bradycardia or cardiac arrest
Major contraindication of Lisinopril and why
Angioedema. Swells lips, tongue, face, throat which can cause airway obstruction.
toxicity, arrhythmias, seizures. what to use if each of these occur
Toxicity- activated charcoal
Arrhythmias- lidocaine
Seizures- diazepam
Absolute Contraindication
Severe liver disease
combining with antidepressants can cause life threatening what
serotonin syndrome
What can suddenly stopping Metoprolol result in
Rebound tachycardia, hypertension, increased myocardial oxygen demand. these can trigger angina or myocardial ischemia