Question

Discuss adverse drug reaction of Losartan, and Losartan with Furosemide, Albuterol, Digoxin in this case study

Jackie Kindling is a 70-year-old female who presents to the ER with shortness of breath and lower extremity edema. She is short of breath with minimal exertion. Jackie sees her doctor regularly for management of diastolic heart failure [AHA Stage C] and chronic asthma. Her last office visit was three weeks ago. Medication changes were made at that time due to her fluid overload and elevated blood pressure. In the ER, Jackie is being assessed and treated for possible diastolic heart failure exacerbation [AHA Stage D]. She is allergic to Sulfa.

Prescribed drugs listed for the treatment: Furosemide 80 MG Oral Tablet; Losartan 50 mg (Cozaar); Albuterol 0.09 MG/ACTUAT Metered Dose Inhaler [Ventolin]' Digoxin 0.0625 MG Oral Tablet.  

Answer 1

LOSARTAN( COZAAR)

• LOSARTAN( COZAAR) is an oral angiotensin receptor blocker prescribed for the treatment of hypertension.

DOSAGE

• Dosage preaparations of cozaar are 25, 50 and 100 mg tablets.

MOA

• Losartan works by blocking a substance in the body that causes blood vessels to tighten. As a result, losartan relaxes the blood vessels. A lower blood pressure will increase the supply of the blood and oxygen to the heart.

WHAT DRUGS, SUBSTANCES OR SUPPLEMENTS INTERACT WITH COZAAR?

• Drug interactions with cozaar may occur with inhibitors of cytochrome P450, potassium sparing diuretics and non steroidal anti inflammatory drugs(NSAIDS)

SIDE EFFECTS

• Diarrhea
• Stomach pain
• Muscle cramps
• Leg or back pain
• Dizziness
• Headache
• Sleep problems
• Tiredness
• Cold or flu symptoms such as stuffy nose, sneezing, sore throat, fever and cough

Adverse effects

• >10% -cough
• 1-10% - Upper respiratory tract infection(8%) , dizzinness(3%), nasal congestion(2%), back pain(2%)

Drug interactions

1. losartan<> digoxin

Losartan and digoxin both increase serum potassium. use caution or monitor

2. Losartan<> furosemide

Losartan increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution.

3. Furosemide<> digoxin

Furosemide increases effects of digoxin by pharmacodynamic synergism. use caution or monitor. Hypokalemia increases digoxin effects

4.Digoxin<> albuterol

Digoxin increases and albuterol decreases serum potassium. effect of interaction is not clear, use caution

5. Albuterol<> furosemide

Albuterol and furosemide both decrease serum potassium. use caution or monitor