3. Introduction
Vasotec (enalapril) is an ACE inhibitor. ACE stands for angiotensin
converting enzyme.
Vasotec is used to treat high blood pressure (hypertension) in
adults and children who are at least 1 month old.
Vasotec is also used to treat congestive heart failure in adults.
Vasotec is also used to treat a disorder of the ventricles (the lower
chambers of the heart that allow blood to flow out of the heart).
This disorder can decrease the heart's ability to pump blood to the
body.
4. Side effects
• , diarrhea.
• Dizziness
• , headache
• , drowsiness.
• Dry mouth
• .Coughing.
• Loss of appetite,
• ability to taste.
• Insomnia.
• Rash,
• itching.
5. Medical uses
• Enalapril is used to treat high blood
pressure (hypertension) in adults and children
who are at least 1 month old.
• Enalapril is also used to treat congestive heart
failure (CHF). CHF is a disorder of the
ventricles (the lower chambers of the heart)
which decreases the heart’s ability to pump
blood to the body.
6. Contraindications
• Enalapril is contraindicated in patients with a history
• of ACE-inhibitor induced angioedema,
• hereditary angioedema,
• idiopathic angioedema.
• The risk of angioedema may be increased in patients
with a history of angioedema unrelated to ACE
inhibitors-Pregnancy
• , angioneurotic edema following other ACE inhibitors,
• bilateral renal artery stenosis.
7. Interactions
• interact with this drug include: aliskiren, certain drugs that
weaken the immune system/increase the risk of infection
(such as everolimus, sirolimus), lithium, drugs that may
increase the level of potassium in the blood (such as ARBs
including losartan/valsartan, birth control pills containing
drospirenone), sacubitril.
• Some products have ingredients that could raise your blood
pressure or worsen your heart failure. Tell your pharmacist
what products you are using, and ask how to use them
safely (especially cough-and-cold products, diet aids,
or NSAIDs such as ibuprofen/naproxen).
• A very serious reaction may occur if you are getting
injections for bee/wasp sting allergy (desensitization) and
are also taking enalapril.
9. Mechanism of Action
• Enalapril, after hydrolysis to enalaprilat, inhibits angiotensin-
converting enzyme (ACE) in human
• subjects and animals. ACE is a peptidyl dipeptidase that catalyzes
the conversion of angiotensin I to the vasoconstrictor substance,
angiotensin II
• . Angiotensin II also stimulates aldosterone secretion by the adrenal
cortex.
• The beneficial effects of enalapril in hypertension and heart failure
appear to result
• primarily from suppression of the renin-angiotensin-aldosterone
system. Inhibition of ACE results in
• decreased plasma angiotensin II, which leads to decreased
vasopressor activity and to decreased
• aldosterone secretion. Although the latter decrease is small, it
results in small increases of serum potassium.
11. Introduction
• Cardizem (diltiazem) is a calcium channel blocker.
It works by relaxing the muscles of your heart and
blood vessels.
• Cardizem is used to treat hypertension (high
blood pressure). It may be used alone or in
combination with other high blood pressure
medications.
• Cardizem is also used to treat chronic
stable angina (chest pain) and angina due to
coronary artery spasm.
13. Medical uses
• Diltiazem is used to prevent chest
pain (angina)
• . It may help to increase your ability
to exercise
• decrease how often you may get angina
attacks.
14. Contraindications
• Diltiazem is contraindicated in patients with
• acute myocardial infarction
• pulmonary congestion
• associated left ventricular dysfunction
• congestive heart failure
• patients with cardiogenic shock,
• Diltiazem should not be used in patients with
systolic blood pressures of less than 90 mm Hg
(i.e., severe hypotension).
15. Interactions
• may interact with this drug include: digoxin, fingolimod.
• Other medications can affect the removal of diltiazem from your body,
which may affect how this medication works. Examples include cimetidine,
azole antifungals such as ketoconazole, macrolide antibiotics such
as erythromycin, rifamycins including rifabutin and rifampin.
• This medication can slow down the removal of other medications from
your body, which may affect how they work. Examples of affected drugs
include aprepitant/fosaprepitant, asunaprevir, buspirone, colchicine,
flibanserin, ivabradine, lomitapide,
certain benzodiazepines (triazolam, midazolam), among others.
• Some products have ingredients that could raise your heart rate or blood
pressure. Tell your pharmacist what products you are using, and ask how
to use them safely (especially cough-and-cold products, diet aids,
or NSAIDs such as ibuprofen/naproxen).
16. Mechanism of Action
• Diltiazem is a non-dihydropyridine calcium channel blocker.
Therapeutic effects occur through various mechanisms. Primarily,
diltiazem inhibits the inflow of calcium ions into the cardiac smooth
muscle during depolarization. Reduced intracellular calcium
concentrations equate to increased smooth muscle relaxation
resulting in arterial vasodilation and, therefore, decreased blood
pressure. Diltiazem is a potent coronary artery vasodilator and is
consequently used for chronic angina and in those patients with
coronary vasospasm. Vasospasm of the coronary arteries can lead
to debilitating conditions such as myocardial infarction.Diltiazem is
a negative inotrope (decreased force) and negative chronotrope
(decreased rate). The combination, along with coronary artery
vasodilation, leads to decreased myocardial oxygen demand,
decreased heart rate, and reduced blood pressure.
17. Credits
Mahmoued Rafe: group leader ,author ,
presentation creation, introductions
,interactions, revision and correction of all parts
Kareem Eissa : Trade Name , Images , Classes
Mahmoud Osama : Contraindications
Mahmoud Mostafa : Side Effects , Medical uses
Hnnen Akef : Mechanism of Action
