#hypertension #onset #medication
And you want to know what’s going on with your kidneys um do you have any kind of stenosis going on do you have any kind of renal impairment so here comes the second tip is to do a blood test hi guys welcome back to farmers in this video we are talking about enalapril i get a lot of questions asking me to dissect common drugs and that’s exactly what i’m
Gonna do i started with the metformin one um and diabetes if you haven’t seen those videos stop this one go watch and then come back but for today we are talking about enala pro now if you have been prescribed enolopril you know that this is for hypertension okay and in some cases it’s also for heart failure now enalapril is a really great drug but there are
A few tricky bits that i think a lot of prescribers don’t bother explaining to their patients so your pharmacotherapy expert is here to give you guys the lowdown and the precautionary notes so that you are so much more aware now remember if you do need an in-depth consultation and review do messages at farmers we do mtm reviews and pharmacotherapy optimization
Because we know how delicate and intricate medicines in combinations can be there’s a lot of negligence unfortunately nowadays in the medical field and by the time you realize it’s often way too late you’re in hospital or dead so it’s really important to pay attention to the finer details especially at the onset of the diagnosis so if you’ve just been diagnosed
With hypertension here are top three things that you need to do before you start any kind of treatment first of all get a confirmation from a secondary healthcare provider a lot of prescribers nowadays are way too quick to prescribe stuff and initiate chronic medicines without proper initiation and diagnosing you typically need to have triplicate results
Of hypertension in order to ascertain that it is actually in fact hypertension i’ve seen instances where somebody walked in once and was immediately diagnosed and started on therapy now i do understand that there are different thresholds if it’s severe like you come with a 190 over i don’t know 100 whatever fine that’s severe but in instances where it’s mild or
Borderline you’re like you’re on 120 130 140 and they still want to immediately initiate you that’s being a little bit lacking caution so you want to ensure that you get three triplicate results so you test today come back next week test again come back the other day test again and that these testings are accurate you want to do it in a sitting down place not when
You’re walking and talking and huffing and puffing you want to make it to make sure that it’s in the morning as early as possible same time every day um and things like that so for more of those details contact us we will help you but yeah so first thing is to ascertain that it is in fact hypertension second thing is to ascertain the type of hypertension because
Yes there are several types and with all the drug classes out there some are more indicated than others you want to make sure that you know what’s going on inside is it hypertension linked to your lifestyle is it stress related is it frank is it cns is it arterial is it whatever you know and you want to know what’s going on with your kidneys do you have any kind
Of stenosis going on do you have any kind of renal impairment so here comes the second um tip is to do a blood test for renal function they have to check your um renal function your hepatic function because enalapril is a pro drug and if you don’t know what that means it means it’s taken um in a form that can’t really do anything unless it gets metabolized and
That metabolism happens in your liver so it is hepatically metabolized into the active form which is enaleprolate so if your liver has a problem metabolizing drugs you won’t get the benefit of enala pro because it’ll just pass unmetabolized and un effective into your kidneys through your renal excretion and fecal matter and then you’re wasting your time so you
Want to check renal function and this is how they’ll they will either run a few blood tests or run some renal function tests and they want to look at your creatinine clearance which is usually the main determinant to see how well you eliminate stuff so this is really important you guys because a lot of prescriptions come through to the pharmacy and you just you
Know do a little history fact-finding and you ask the person did the doctor check this and that any other no did the doctor ask you about this no did the doctor even pretend to check um for any hepatic or renal issues no and you’re like and i get it like fine most people don’t have anything most people are fine but it’s for the one or two that are not fine it’s
For the exception that we do all this screening it’s for the minority it’s for the peculiar cases um it’s not always gonna show like nobody walks in with you know obvious angioedema or um any kind of other swelling like you know um you know the obvious cases but what about the borderline cases what about the invisible cases what about the a little more subtle
Cases so yeah anyway these are the precautions guys check for them ask your prescriber for them and then be safe okay so once you now start the inaudible right say you’ve checked everything you’re fine and now you’ve started there are initiating things that you also need to look out for because the nalopro has two major side effects to be wary of and these
Are angioedema that happen in you know rare cases but it still happens and this is what you will look like puffy in the face puffy on the hands puffy on the feet you’d look like you had a black eye or a beast on you um a lot of swelling and stuff around the eyes the mouth the lips and even sometimes like the forehead like you’ll get a rash so that’s very
Important to note if you do develop that at the beginning or even anytime during your treatment stop okay stop and go see your doctor immediately the second thing that may develop especially in the beginning is a cough if you have just started enalopril and you suddenly develop a cough that is an issue not to overlook or you know go immediately see your doctor
And get it swapped out and you might just need to be swapped out to another hypertension medicine okay so those are the two really big warning side effects to note um another one is impotence now if you all of a sudden feel or become really impotent meaning you cannot get an erection or you have erectile dysfunction you also need to go see your doctor you may
Get substituted on something else or re-evaluate it okay the thing with enalapril right it is an ace inhibitor that means it’s an angiotensin converting enzyme inhibitor and it’s gonna inhibit um bradykinen and all of that but there are a lot of other types so don’t despair if this one is not working for you there are others you know they might put you on
An angiotensin receptor blocker or some of the others now the thing i want to note as well here is that the dosage needs to be titrated for many patients that are initiated on okay you can start at 10 um some people will go to 20 milligrams a day but it’s important to note that you need to take this medicine first thing in the morning when you wake up and it’s
Also really important to note that you need to keep to the same time every day so that it performs 24 hour in your body and it becomes clockwork okay don’t take it at 10 today and then take it at like three tomorrow and then take it at six the next day like no put an alarm first thing when you wake up you don’t really need to eat with this unless you have like
Stomach ulcers or other stomach issues where you need something to coat the stomach um have a piece of fruit and be done you know it doesn’t need when we say eat with your food it’s also not like the a buffet type of you know it’s not like plates full of food we just mean um and that serves two different purposes i’ll speak on that in my other video food is not
Necessarily for absorption it’s sometimes as protective so um yeah same time every day every morning and if you do skip a dose note how long ago it should have been and see if you can either take it immediately or like if it’s still morning time or if you have to wait till the next day and then let it kick in again don’t take double doses or like you know
Double up if you all of a sudden remember and it’s midnight and the next dose is at like six just wait until six don’t offset the whole thing okay so that’s my five cents on enapril you guys i hope this video helps somebody if you are on enalapril or any other medication especially if you’re taking three or more chronic medicines per day like through your whole
Regimen um do get a review i mean it feels like it’s not necessary but trust me adjustments come in various shapes or forms we actually guarantee at farmers that if we don’t find an adjustment in your regimen we’ll give you a refund because that’s how prevalent and so i noticed these errors are and we always can tweak a regimen to make a difference to optimize
Your health outcomes and to give you a better quality of life so contact farmers and we’ll see you in the next video if this is helpful insightful or um entertaining put a big thumbs up and share the video to help somebody and if you’re not yet subscribed subscribe because there’s more coming i’ll see you later guys bye
Transcribed from video
Enalapril | Signs to Watch Out For | Prescription Safety Review By PHARMERS