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Healthcare Communications

 

 

Enalapril

- Inhibits angiotensin converting enzyme

- Decreased Angiotensin II
-----> peripheral vasodilation
------> decreased peripheral resistance

- Decreased Angiotensin II
------> decreased Aldosterone
------> decreased Na+ & H2O retention

- Useful in hypertension, congestive cardiac failure

 

Pharmacokinetics

- Absorbed from G. I. Tract
- Absorption not affected by food
- Converted to active form Enalaprilat
- Excreted as Enalaprilat and as unchanged drug in urine & faeces

 

 

Enalapril In Hypertension

- Decreased Angiotensin II + Decreased Aldosterone
------> Decreased Peripheral resistance
------> Decreased B. P.
- Effect lasts 24 hours, hence convenience of once daily administration
- Useful in all grades of hypertension, renal hypertension, diabetic nephropathy with hypertension
- Particularly useful in obese / diabetic hypertensives

 

Enalapril In Congestive Cardiac Failure (CCF)

- Reduces afterload ----> Improves Cardiac output
- Forms basic therapy in CCF : diuretics / digoxin may be added in selected cases

 

Dosage

Hypertension :
Initially 5 mg/day (2.5 mg in Renal impairment / elderly) Dose to be titrated according to response
Usual Maintenance Dose :
10-20 mg/day Severe Hypertension : Upto 40 mg/day

CCF :
Initially : 2.5 mg/day Maintenance : 5-20 mg/day

 

Tolerability

- Generally well tolerated
- Skin rashes, cough, angioedema

 

 

Salient Features

- ACE inhibitor
- Reduces peripheral resistance
- Effective in hypertension and congestive cardiac failure - Convenient once daily dosage
- Most widely used among the ACE inhibitors