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Actions: competitive inhibitor or angiotensin-converting enzyme (ACE); results in lower levels of angiotensin II which causes an increase in plasma renin activity and a reduction in aldosterone secretion.

Indications: hypertension, congestive heart failure, left ventricular dysfunction after myocardial infarction. Preparation: enalapril is PO; enalaprilat is IV. Dose (hypertension): adult: 2.5-5 mg/day PO (enalapril) then increase as required (usual dose: 1040 mg/day in 1-2 divided doses); 0.625-5 mg/dose IV (enalaprilat) over 5 minutes every 6 hours Dose (heart failure): adult: initiate with 2.5 mg PO (enalapril) 1-2 times daily (usual dose: 5-20 mg/day). Dose (ped): enalapril (PO): 0.1 mg/kg/day increasing as needed over 2 weeks to 0.5 mg/kg./day; enalaprilat (IV): 5-10 mcg/kg/dose administered q8-24 hrs.

Clearance: hepatic metabolism of enalapril to active metabolite (enalaprilat); renal and fecal elimination. Contraindications: idiopathic or hereditary angioedema, bilateral renal artery stenosis, primary hyperaldosteronism, pregnancy. Adverse effects: causes increased serum potassium, increased renal blood flow volume-responsive hypotension; can cause angioedema, blood dyscrasia, cough, lithium toxicity, worsening of renal impairment; subsequent doses are additive. Comments: dosing needs to be adjusted in renal and hepatic impairment.

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Blood Pressure Health

Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

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