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Name: Lisinopril

Pregnancy Category C

Drug classes

Mechanism of action

Renin, synthesized by the kidneys, is released into the circulation where it acts on a plasma precursor to produce angiotensin I, which is converted by angiotensin-converting enzyme to angiotensin II, a potent vasoconstrictor that also causes release of aldosterone from the  adrenals. Lisinopril blocks the conversion of angiotensin I to angiotensin II, leading to decreased BP, decreased aldosterone secretion, a small increase in serum potassium levels, and sodium and fluid loss.

Indications

  • Treatment of hypertension alone or in combination with thiazide-type diuretics
  • Adjunctive therapy in CHF for patients not responding adequately to diuretics and digitalis

Contraindications/cautions

  • Contraindicated in the presence of allergy to lisinopril or enalapril.
  • Use caution in the presence of impaired renal function, CHF, salt or volume depletion, and lactation.

Adverse effects

  • CNS: Headache, dizziness, insomnia, fatigue, paresthesias
  • GI: Gastric irritation, nausea, diarrhea, aphthous ulcers, peptic ulcers, dysgeusia, cholestatic jaundice, hepatocellular injury, anorexia, constipation
  • CV: Orthostatic hypotension, tachycardia, angina pectoris, MI, Raynaud's syndrome, CHF, severe hypotension in salt or volume depleted patients
  • Hematologic: Neutropenia, agranulocytosis, thrombocytopenia, hemolytic anemia, fatal pancytopenia
  • GU: Proteinuria, renal insufficiency, renal failure, polyuria, oliguria, frequency
  • Other: Angioedema (particularly of the face, extremities, lips, tongue, larnyx; death has been reported with airway obstruction); cough, muscle cramps, impotence

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