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Average wholesale price (AWP, for AB-rated generic when available) for quantity listed Source: Red Book Update, Vol 26, No 3, March 2007 AWP may not accurately represent the actual pharmacy cost because wide contractual variations exist among institutions 2 Agents with 1 selectivity are less likely to precipitate bronchospasm and decreased peripheral blood flow in low doses, but selectivity is only relative 3 Agents with ISA cause less resting bradycardia and lipid changes 4 MSA generally occurs at concentrations greater than those necessary for -adrenergic blockade The clinical importance of MSA by -blockers has not been defined 5 Adverse effects of all -blockers: bronchospasm, fatigue, sleep disturbance and nightmares, bradycardia and atrioventricular block, worsening of congestive heart failure, cold extremities, gastrointestinal disturbances, impotence, triglycerides, HDL cholesterol, rare blood dyscrasias ISA, intrinsic sympathomimetic activity; MSA, membrane-stabilizing activity; ANA, antinuclear antibody; LE, lupus erythematosus; MI, myocardial infarction; SR, sustained release; 0, no effect; +, some effect; ++, moderate effect; +++, most effect

Cost of 30 Days Treatment (Average Dosage)1 $3150 $3900 $4560 $3570 $3180 $4410 $6210 $3660 $5190 $3840 $5490 $7440 $6540 $6930 $5640 $6840 Hyperkalemia, renal dysfunction, rare angioedema Combinations have additional side effects Contraindicated in pregnancy Losartan has a very flat doseresponse curve Valsartan and irbesartan have wider doseresponse ranges and longer durations of action Addition of lowdose diuretic (separately or as combination pills) increases the response

Drug ACE Inhibitors Benazepril Captopril Enalapril Fosinopril Lisinopril Moexipril Perindopril Quinapril Ramipril Trandolapril Candesartan cilexitil Candesartan cilexitil/ HCTZ Eprosartan Eprosartan/HCTZ Irbesartan Irbesartan and HCTZ

From the Help screen, pressing F9 or clicking the Technical Info button, depending on your display option, will give you the technical information screen shown in Figure 1-9

Proprietary Name Lotensin Capoten Vasotec Monopril Prinivil, Zestril Univasc Aceon Accupril Altace Mavik Atacand Atacand HCT Teveten Teveten HCT Avapro Avalide

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Initial Dosage 10 mg once daily 25 mg twice daily 5 mg once daily 10 mg once daily 5 10 mg once daily 75 mg once daily 4 mg once daily 10 mg once daily 25 mg once daily 1 mg once daily 16 mg once daily 16 mg/125 mg once daily 600 mg once daily 600 mg/125 mg once daily 150 mg once daily 150 mg/125 mg once daily

Dosage Range 5 40 mg in 1 or 2 doses 50 300 mg in 2 or 3 doses 5 40 mg in 1 or 2 doses 10 80 mg in 1 or 2 doses 5 40 mg once daily 75 30 mg in 1 or 2 doses 4 16 mg in 1 or 2 doses 10 80 mg in 1 or 2 doses 25 20 mg in 1 or 2 doses 1 8 mg once daily 8 32 mg once daily 8 32 mg of candesartan once daily 400 800 mg in 1 2 doses 600 mg/125 mg or 600 mg/25 mg once daily 150 300 mg once daily 150 300 mg irbesartan daily

Cost per Unit $105/20 mg $065/25 mg $152/20 mg $119/20 mg $106/20 mg $147/75 mg $207/8 mg $122/20 mg $173/5 mg $128/4 mg $183/16 mg $248/16 mg/ 125 mg $218/600 mg $231/600 mg/ 125 mg $188/150 mg $228/150 mg

Adverse Effects Cough, hypotension, dizziness, renal dysfunction, hyperkalemia, angioedema; taste alteration and rash (may be more frequent with captopril); rarely, proteinuria, blood dyscrasia Contraindicated in pregnancy

Comments More fosinopril is excreted by the liver in patients with renal dysfunction (dose reduction may or may not be necessary) Captopril and lisinopril are active without metabolism Captopril, enalapril, lisinopril, and quinapril are approved for congestive heart failure

Retrospective studies suggest that patients who had previously undergone coronary artery bypass grafting (CABG)

Independent Predictors of Postoperative Cardiac Complications 1 Intrathoracic, intraperitoneal, or infrainguinal vascular surgery 2 History of ischemic heart disease 3 History of congestive heart failure 4 Insulin treatment for diabetes mellitus 5 Serum creatinine level > 2 mg/dL 6 History of cerebrovascular disease

A matchcode is a comparison key It allows you to locate the key of a particular database record by entering a field value contained in the record The system then displays a list of records matching the specifications for you to select from An example of this would be searching for the customer number in the sales order When you press F4 from within the customer number field, you will have an option to select a suitable matchcode to obtain the customer number you are after, as shown in Figure 1-10 You may also click the drop-down icon from within this selection screen to display a number of different matchcodes to choose from, as shown in Figure 1-11

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