Valsartan Hydrochlorothiazide Micardis Plus 4080 mg Telmisartan

Valsartan hydrochlorothiazide micardis plus 4080 mg

This preview shows page 8 - 12 out of 142 pages.

Valsartan + Hydrochlorothiazide Micardis Plus 40,80 mg Telmisartan + Hydrochlorothiazide Co-Aprovel … X-Tension plus 150,300 mg Irbesartan + Hydrochlorothiazide B Blockers + Diuretics Blokium Diu Atenolol + Chlorthalidone Bisocard Plus Concor Plus 5,10 mg Bisoprolol + Hydrochlorothiazide
Image of page 8
Dr. Ali Ragab Ali Page 9 GoLdeN TabeLs Side effect based choice table Contraindicated in Side effect Drug K preparations / K sparing diuretics Bronchial Asthma If serum creatinine > 1.5 mg% Pregnancy Bilateral renal artery stenosis Hyperkalemia Dry cough Renal impairment ACE inhibitors Bronchial asthma Heart block DM Bronchospasm Bradycardia Masking signs of hypoglycemia B Blockers Heart block Ischemic heart diseases e nifedipine Heart failure Bradycardia Tachycardia e nifedipine cardiac contractility Calcium Ch. Blockers Hypertension in certain situation table Contraindicated drugs Preferred drugs Clinical situation Hydralazine … Minoxidil B blocers / CCBs Coronary artery disease CCBs Diuretics / ACE inhibitors Heart failure K sparing diuretics Methyl dopa / Loop diuretics Renal failure ACE inhibitors Bilateral renal a stenosis B Blockers Bronchial asthma B Blockers DM Diuretics / ACE inhibitors Methyl dopa Pregnancy B blockers Selective α 1 blockers Raynaud's Age Stage based choice table > 55 years < 55 years C or D A or B Stage 1 A or B + C or D Stage 2 A or B + C + D Stage 3 Add either α blocer or spironolactone or other diuretics Resistant HTN
Image of page 9
Dr. Ali Ragab Ali Page 10 AIM of HTN management 1. Keep blood pressure < 140/90 2. Keep blood pressure < 130/80 in DM and renal impairment 3. Prevent target organ damage Training cases Case 1 Femal Patient aged 44 years e blood pressure more than 150/95 mmHg e no other abnormalities R/ Capoten 25 mg twice daily Or R/ Ezapril 10 mg once daily Or R/ Concor 5 mg once daily Analysis 1. The patient is stage 1 so we use only one drug 2. The patient is below 55 years so we use ACE inhibitors or B blockers NB Follow up is after 10 days We can increase either the dose of the drug or the frequency according to the patient's response Case 2 Male patient aged 37 years e blood pressure 140/90 and he is diabetic 5 years ago with no other abnormalities R/ Tritace 1.25 mg once daily Analysis The patient is diabetic e blood pressure more 130/80 / ACE inhibitors are recommended
Image of page 10
Dr. Ali Ragab Ali Page 11 Case 3 Femal patient aged 62 years e blood pressure 155/100 mmHg on hemodialysis e no other abnormalities R/ Alkapress 5 mg once daily Or R/ Aldomet 250 mg twice daily Or R/ Lasix 40 mg once daily Analysis 1. In renal failure methyl dopa, CCBs and loop diuretics are preferred 2. While ACE inhibitors and K sparing diuretics are contraindicated Case 4 Male patient aged 34 years e blood pressure 185/110 mmHg, on aminophylline with no other abnormalities R/ Alkapress 5 mg once daily + R/ Lasilactone 50 mg once daily Or R/ X-Tension plus 150 mg once daily Analysis 1. The patient is stage 2 so drug combination is recommended 2. The patient is asthmatic or COPD B blockers is not preferred because of bronchospasm 3.
Image of page 11
Image of page 12

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture