Dental Concerns

General

1. Monitor vital signs at every appointment because of cardiovascular side effects.

2. A semisupine position for the dental chair may be necessary to help minimize or avoid GI adverse effects.

KAP-toe-prill]

Pregnancy Category: C (first trimester); D (second and third trimesters) Alti-Captopril M, Apo-Capto M, Capoten, Gen-Captopril M, Med-Capto-

136 CAPTOPRIL

pril M, Novo-Captoril M, Nu-Capto M [Rx]

Classification: Antihypertensive, inhibitor of angiotensin synthesis

■ See also Angiotensin-Converting Enzyme Inhibitors.

Action/Kinetics: Onset: 15 min. Peak serum levels: 30-90 min; presence of food decreases absorption by 30%-40%. Plasma protein binding: 25%-30%. Time to peak effect: 60-90 min. Duration: 6-12 hr. t!/2, normal renal function: 2 hr; t!/2, impaired renal function: 3.5-32 hr. More than 95% of absorbed dose excreted in urine (40%-50% unchanged). Food decreases bioavailability of captopril by 30%-40%.

Uses: Antihypertensive, step I therapy in clients with normal renal function. Concomitant use with diuretic therapy may, however, cause precipitous hypotension. In combination with diuretics and digitalis in treatment of CHF not responding to conventional therapy. To improve survival following MI in clinically stable clients with LV dysfunction manifested as an ejection fraction of 40% or less. Treatment of diabetic nephropathy (proteinuria > 500 mg/day) in those with type I insulin-dependent diabetes and retinopathy. Non-FDA Approved Uses: Rheumatoid arthritis, hypertensive crisis, neonatal and childhood hypertension, hypertension related to sclero-derma renal crisis, diagnosis of anatomic renal artery stenosis, diagnosis of primary aldosteronism, Raynaud's syndrome, hypertension of Takayasu's disease, idiopathic edema, and Bart-ter's syndrome.

Contraindications: Use with a history of angioedema related to previous use of ACE inhibitors. Special Concerns: Use with caution in cases of impaired renal function and during lactation. Use in children only if other antihypertensive therapy has proven ineffective in controlling BP. May cause a profound drop in BP following the first dose.

Side Effects: Dermatologie. Rash (usually maculopapular) with pruritus and occasionally fever, eosino-philia, and arthralgia. Alopecia, erythema multiforme, photosensitivity, exfol-iative dermatitis, Stevens-Johnson syndrome, reversible pemphigoid-like lesions, bullous pemphigus, on-ycholysis, flushing, pallor, scalded mouth sensation. Oral: Dysgeusia, aphthous ulcers, dry mouth, glossitis. GI: N&V, anorexia, constipation or diarrhea, gastric irritation, abdominal pain, peptic ulcers, dyspepsia, pancreatitis. Hepatic: Jaundice, cholestasis, hepatitis. CNS: Headache, dizziness, insomnia, malaise, fatigue, pares-thesias, confusion, depression, nervousness, ataxia, somnolence. CV: Hypotension, angina, MI, Raynaud's phenomenon, chest pain, palpitations, tachycardia, CVA, CHF, cardiac arrest, orthostatic hypotension, rhythm disturbances. Renal: Renal insufficiency or failure, proteinuria, urinary frequency, oliguria, polyuria, nephrotic syndrome, interstitial nephritis. Respiratory: Bronchospasm, cough, dyspnea, asthma, pulmonary embolism, pulmonary infarction. He-matologic: Agranulocytosis, neutro-penia, thrombocytopenia, pancyto-penia, aplastic or hemolytic anemia. Other: Decrease or loss of taste perception with weight loss (reversible), angioedema, asthenia, syncope, fever, myalgia, arthralgia, vas-culitis, blurred vision, impotence, hyperkalemia, hyponatremia, myas-thenia, gynecomastia, rhinitis, eosin-ophilic pneumonitis. Drug Interactions: See also An-giotensin-Converting Enzyme Inhibitors.

How Supplied: Tablet: 12.5 mg, 25

Dosage-

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