BIOMEDICINE – CARDIOVASCULAR: 01.01 – Renin–Angiotensin– Aldosterone System (RAAS) (ASE Inhibitor)
ACTION: Suppresses renin-angiotensin-aldosterone system (prevents conversion of angiotensin I to angiotensin II, a potent vasoconstrictor). Decreases plasma angiotensin II, increases plasma renin activity, decreases aldosterone secretion. This mechanism can also lead to the accumulation of bradykinin, a substance that can irritate the airways.
INDICATIONS: Elevated blood pressure.
SIDE EFFECTS:
Frequent: (39%) Decreased appetite; 20-30% of patients taking lisinopril experience dry, persistent cough .
Occasional: (19%–9%) Insomnia, upper abdominal pain, headache, irritability, vomiting, weight loss.
Rare: (6%–2%) Nausea, dry mouth, dizziness, rash, affect change, fatigue, tic.
ADVERSE EFFECTS/TOXIC REACTIONS: Abrupt withdrawal following prolonged administration of high dosage may produce extreme fatigue (may last for weeks). Prolonged administration to children with ADHD may produce a suppression of weight and/or height patterns. May produce cardiac irregularities, psychotic syndrome
INTERACTIONS:
DRUG: Diuretics may increase effects. Risk of toxicity of lithium. NSAIDs may decrease effects. Potassium-sparing diuretics, potassium supplements may cause hyperkalemia. May increase hypoglycemic effect of oral hypoglycemic drugs.
HERBAL: Ephedra, ginseng, licorice, yohimbe may worsen hypertension. Black cohosh, periwinkle may increase antihypertensive effect.
LAB VALUES: May increase serum BUN, alkaline phosphatase, bilirubin, creatinine, potassium, ALT, AST. May decrease serum sodium. May cause positive ANA.
(Prinivil, Zestril)
TCM – Chapter 2: Substances that Clear Heat
Enters: LV, GB, K, Ht, Lu
Temperature: cold
Taste: bitter, acrid
ACTION: Clear heat, Subdue Yang, Course Qi downward
INDICATIONS: Yang Rising, Liver Fire
Tongue: pink, red.
Pulse: wiry
RATIONALE: Its bitter taste and cold property clear heat, and its strong downward-moving direction subdues Liver Yang Rising. Acrid properties may excessively irritate the Lungs, causing a dry cough, especially with preexisting Dryness due to Spleen deficiency.
CAUTION: St/Sp deficiency, Qi deficiency.
NOTE: Excessive use may deplete the Kidneys and damage the Mingmen.
MODIFICATIONS: To protect Sp/St add Da Zao. To address the cause of Yang rising, add herbs that nourish K Yin and Liv Blood