This medication reduces the activity of the renin-angiotensin-aldosterone system. In which it prevents the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. This also lowers plasma angiotensin II, raises plasma renin activity, and lowers aldosterone secretion.

Therapeutic Effect: Improves a person’s cardiac output and exercise tolerance by lowering peripheral artery resistance and pulmonary capillary wedge pressure.

Hypersensitivity to captopril. History of angioedema from previous treatment with ACE inhibitors, concomitant use with aliskiren in patients with diabetes mellitus

Cautions: Renal impairment, hypertrophic cardiomyopathy with outflow obstruction, before, during, or immediately after major surgery. Unstented unilateral/bilateral

Pharmacotherapeutic: Angiotensin-converting enzyme (ACE) inhibitor

Clinical: Antihypertensive, vasodilator

Baseline assessment

• Obtain the patient’s blood pressure immediately before each dose in addition to regular monitoring. If hypotension occurs during monitoring, place the patient in supine position with his/her legs elevated.

Intervention/Evaluation

• Assess the patient’s skin for rash and pruritus. 
• Assist with ambulation if dizziness occurs.
• Monitor urinalysis for signs of proteinuria.
• Monitor serum potassium levels in pts on concurrent diuretic therapy.
• Monitor the patient’s blood pressure, serum BUN, creatinine, CBC.
• Discontinue medication, contact physician if angioedema occurs.

Patient/Family Teaching

• It may take many weeks for the whole therapeutic effect of blood pressure lowering to take effect.
• Skipping dosages or stopping medications deliberately might result in severe rebound hypertension.
• Limit alcohol consumption
• If you notice swelling of the face, lips, or tongue, trouble breathing, vomiting, diarrhea, heavy sweating, dehydration, persistent cough, sore throat, or fever, call the doctor right away.
• Slowly rise from a seated or lying position

Pharmacotherapeutic: Angiotensin II receptor antagonist

Clinical: Antihypertensive

This medication blocks angiotensin II vasoconstriction and aldosterone-secreting actions by reducing angiotensin II binding to AT1 receptors.

Therapeutic Effect: It causes vasodilation, decreases peripheral resistance, decreases B/P.

Hypertension

• PO: ADULTS, ELDERLY: Initially, take the medication 50 mg once daily. Maximum: this medication may be given once or twice daily, with total daily doses ranging from 25–100 mg only.

• CHILDREN 6–16 YRS: 0.7 mg/kg once daily. Adjust dose to BP response. Maximum: 100 mg/day.

Treatment for Hypertension. Used alone or in conjunction with other antihypertensive medications. Diabetic nephropathy with increased creatinine and proteinuria (in patients with type 2 diabetes and a history of hypertension), stroke prevention in patients with hypertension and left ventricular hypertrophy

Losartan hypersensitivity Concurrent usage of aliskiren in diabetic patients.

Cautions: Renal/hepatic dysfunction, unstented renal artery stenosis, and substantial aortic/mitral stenosis Use of potassium supplements at the same time. Patients with a history of angioedema

Frequent: possible upper respiratory tract infection.

Occasional: Dizziness, diarrhea, cough.

Rare: Insomnia, dyspepsia, heartburn, back/leg pain, muscle cramps, myalgia, nasal congestion, sinusitis, depression.