INOTROPIC AGENTS,DRUGS USED IN CHF
International Brand Name:
1. Cough 2. Angioedema 3. Hypotension 4. Bradycardia 5. Hyperkalemia 6. Rashes 7. Urticaria 8. Swelling of lips, mouth, nose and larynx 9. Fetopathic in later half of pregnancy 10. Headache
1. Hypersensitivity to the drug 2. Renal artery stenosis 3. Aortic stenosis 4. Coarctation of aorta
1. Renal impairment 2. Patient at high risk of cardiogenic shock, severe heart failure etc 3. Anaesthesia and surgery 4. Stops diuretics 2 to 3days before Enalapril therapy
Antacids: Decrease effeciency of Captopril. Indomethacin: Reduces hypotensive effect. Digoxin: Increases plasma digoxin levels. Potassium preparations & potassium sparing diuretics: Hyperkalaemia and increased risk of renal failure. Lithium: Toxicity due to increased serum concentration of lithium. Immunosuppressive Drugs : Increased risk of bone marrow depression. Antidepressants, diuretics, Beta-blockers, Nitrates, Dopaminergics, Calcium channel blockers, Phenothiazines: Enhance hypotensive effect. Morphine: Enhanced analgesic effect and respiratory depression.
Adult:- 5mg once daily. Increases the dose to 10 to 20mg once daily or as two divided doses depending on patient`s response if required. Maximum dose: 40mg/day In patient on diuretic therapy & In CHF patients starts the dosage with 2.5mg once daily dosage and increases to usual dosage. Left ventricular dysfunction: Starts with 2.5mg orally twice daily. Increases the dosage up to 20mg/day in two divided doses. Children : 0.1 to 0.5mg/kg/day once daily or in divided doses as suspension of crushed tablets.