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Medications and What They Do
A subject of great concern to health
care providers and their clients everywhere is medication.
Sometimes our Doctor changes our
medications around and we may not realize that he is actually stopping another
medication we have been taking or we may forget just what he told us to no
longer take. Sometimes we decide to stop taking a medication because we
feel so much better or it is so expensive. For any number of
reasons, we may stop taking medications that is necessary for our health and
this may end up with being hospitalized again.
To help prevent this always go to the
same pharmacy. In this way the pharmacist can get to know you and all of your
medications. If there is a question about dosage or a conflicting medication, he
can check with your Dr. and clarify the situation. Also the pharmacist
will explain your medications and what they are for, what you can or can not do
while taking a medication if there are any side effects, etc.
If for some reason you want to take an
over the counter medication for a cold flu or whatever, it would be wise to
check with your Doctor or pharmacist to be sure they do not interfere with your
other medications.
When you feel good again and the
medication is not one your physician gave you a time limit for, DO NOT stop the
medication because you feel better or it is too expensive. This could lead
to further medications or hospitalization.
Many of us require
medications to assist us with keeping our blood pressure in a level that will
help to prevent damage to our kidneys and decrease the chance of cardiac
problems and stroke that the continued increased pressure in our vessels could
cause. There are many different antihypertensive drugs on the market today and
I will discuss a few of them. Most of them have about the same properties or
effects though they may work on different parts of our body to obtain the
effects. :
Avapro
(irbesartan)
Avapro lowers our blood pressure by
helping prevent the conversion of angiotension I to angiotension II thus
lowering the blood pressure and are used to treat heart failure and other
diseases. Dosages come in 75 mg, 150 mg and 300 mg. Dosages vary depending on
age and are built up slowly in case symptomatic hypotension should happen.
Some of the side effects you may
experience are:
The herbal
vitamin containing Ma-huang: could interfere with the lowering of your blood
pressure so you should avoid taking these drugs together.
Diuretics such as lasix (furosemide) or
maxide may given to take concurrently with Avapro to assist in the lowering of
blood pressure. Dizziness or a drop in blood pressure could occur in patients
with renal disease and Diabetes Type II patients.
Clonidine
(Catapres, Dixarit†‡,
Duraclon)
How it works is unknown. Thought to
stimulate receptors that inhibit the central vasomotor centers, decreasing
outflow to the heart, kidneys, and peripheral vasculature, thus lowering
peripheral vascular resistance, blood pressure, and heart rate.
This medication is
often given to lower blood pressure rapidly in some hypertensive emergencies.
Adverse reactions :
Drug interactions:
Clonidine may cause drowsiness but that
this adverse effect usually diminishes over 4 to 6 weeks.
Inderal
(Propanolol)
Inderal is a nonselective beta blocker
that reduces cardiac oxygen demand by blocking catecholamine-induced increases
in heart rate, blood pressure, and force of myocardial contraction. Depresses
renin secretion and prevents vasodilatation of cerebral arteries.
Comes in Tablets: 10 mg, 20 mg,
40 mg, 60 mg, 80 mg, 90 mg
Adverse reactions
Interactions
Drug-drug
Drug-herb
Effects on lab test results
May
increase BUN, transaminase, alkaline phosphatase, and LDH levels. May decrease
granulocyte count
Lisinopril
(Prinivil or Zestril)
Just how Lisinopril works to
lower our blood pressureis not known exactly but is believed to be the result of
suppression of the renin-angiotensin-aldosterone system.
Lisinopril comes in tablets 2.5 mg, 5
mg, 10 mg, 20 mg, 40 mg. Initially, 10 mg P.O. daily for patients not taking
a diuretic. Most patients are well controlled on 20 to 40 mg daily as a single
dose. For patients taking a diuretic, initially, 5 mg P.O. daily.Lisinopril may
affect your creatinine clearance level and should be adjusted according to lab
values should this occur. If your Sodium level is below 130 and Creatinine
clearance is less than 30, the dosage should start at the lower level of 2.5
mg.
As with other antihypertensive medications, there
are some adverse affects to watch for:
There are also many drugs that may have an interaction
with Lisinopril:
Drug-drug
Drug-herb
May increase BUN, creatinine,
potassium, and bilirubin levels.
May increase liver function test
values.
Norvasc
(amlodipine
besylate)
Norvasc is usually given for chronic
stable angina, and ultimately lower the blood pressure. It inhibits
calcium influx across cardiac and smooth-muscle cells,and dilates coronary
arteries and arterioles.
Dosage is usually determined as:
Some adverse reactions to Norvasc are:
Drug interactions with food:
Grapefruit juice: May increase drug
level and adverse reactions. Discourage use together.
Procardia
(Adalat,
Adalat CC, Adalat PA†, Adalat XL†, Apo-Nifed†, Nifedical XL, Novo-Nifedin†,
Nu-Nifed†, Procardia, Procardia XL)
Indications & dosages
Angina
Adults: Initially, 10 mg (short-acting
capsules) P.O. t.i.d. Usual effective dosage range is 10 to 20 mg t.i.d. Some
patients may require up to 30 mg q.i.d. Maximum daily dose is 180 mg. Adjust
dosage over 7 to 14 days to evaluate response. Or, 30 to 60 mg (extended-release
tablets, except Adalat CC) P.O. once daily. Maximum daily dose is 120 mg. Adjust
dosage over 7 to 14 days to evaluate response.
Hypertension
Adults: 30 or 60 mg P.O.
(extended-release) once daily. Adjusted over 7 to 14 days. Doses larger than 90
mg (Adalat CC) and 120 mg (Procardia XL) aren't recommended.
It is not known how this works but is
thought to decrease contractility and oxygen demand on your heart muscle. Also
may dilate coronary arteries and arterioles.
Adverse reactions:
Interactions may occur:
Drug-drug
Drug-herb
Drug-food
Effects on lab tests:
May increase
ALT, AST, alkaline phosphatase, and LDH levels.
Vasotec
(enalapril maleate)
Indications & dosages
Hypertension
Adults: In patients not taking
diuretics, initially, 5 mg P.O. once daily; then adjusted based on response.
Usual dosage range is 10 to 40 mg daily as a single dose or two divided doses.
Action
This is unknown. but is thought to
inhibit ACE, preventing conversion of angiotensin I to angiotensin II, a potent
vasoconstrictor. Less angiotensin II decreases peripheral arterial resistance,
thus decreasing aldosterone secretion, thereby reducing sodium and water
retention and lowering blood pressure.
Adverse reactions
Drug Interactions
Effects on lab test results
Verapamil
(Veralen, Calan)
Action is not clearly defined.
Verapamil is a calcium channel blocker that inhibits calcium ion influx across
cardiac and smooth-muscle cells, thus decreasing myocardial contractility and
oxygen demand; it also dilates coronary arteries and arterioles
Indications & dosages
Vasospastic angina (Prinzmetal's or
variant angina);
To prevent paroxysmal supraventricular
tachycardia
Digitalized patients with chronic
atrial fibrillation or flutter
Hypertension
Adverse reactions
Interactions
Drug-drug
These are just a few of the drugs given to lower
the blood pressure. As you can see there are many and several ways they work and
really so many different possible interactions that we must be careful that the
Pharmacist that gives our prescription and the Physician that orders it are
aware of what other medications or over the counter medications we are taking.
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