好網站~Hospitalist Handbook UCSF

Hospitalist Handbook UCSF 

02. ACE Inhibitor Conversion Table

Resident Editor: Carine Davila, MD
Faculty Editor: Elisabeth Askin, MD

Drug	Recommended dosing frequency	Starting dose	Approximate dose equivalence	Usual maintenance dose	Maximum dose
Benazepril	Daily or two divided doses	10mg (5mg if pt on diuretic)	10 mg	20-40 mg	80mg/day
Captopril	BID (HTN) TID (HF)	25mg (HTN) 6.25 mg (HF)	12.5 mg	50-100 mg/day	200mg/day HTN) 150mg/day (HF)
Enalapril	Daily (HTN) BID (HF)	5mg (HTN) 2.5 mg (HF)	5 mg	10-40mg (HTN) 2.5-20 mg (HF)	40mg/day
Lisinopril	Daily	10mg (HTN) 5 mg (HF)	10 mg	20-40 mg	40mg/day
Ramipril	Daily	1.25-2.5mg	2.5 mg	2.5-10mg	20mg/day (HTN) 10mg/day (HF)

 

• Disclaimer: Starting doses and titration schedule depend on individual clinical scenario and are particularly important to review with renal failure that may have different starting dose recommendations*.
• In addition to the above, there are some less commonly used ACEi that are listed here with their dose equivalence:
  • Fosinopril: 10mg
  • Moexipril: 7.5mg
  • Perindopril: 4mg
  • Quinapril: 10mg
  • Trandolapril: 1mg

Reference:

Greater Rochester Independent Practice Association. Approximate Dose Conversions. http://gripa.org/member-services-care-management-pharmacy-tidbits.asp. October 2006. Accessed October 5, 2014.

Yancy et al. 2017 ACC/AHA/HFSA Heart Failure Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure. Circulation. http://circ.ahajournals.org/content/circulationaha/early/2017/04/26/CIR.0000000000000509.full.pdf. Accessed April 15, 2018.

UNC Center for Excellence in Chronic Illness Care. https://www.med.unc.edu/im/files/enhanced-care-files/HTN_Protocol_6.05.pdf. Accessed April 15, 2018.

Micromedex. Individual Drugs. Accessed May 29, 2018. 

-------------------------------------------

03. Beta Blocker Conversion Table

Resident Editor: Patrick Azcarate, MD
Faculty Editor: Elisabeth Askin, MD

Drug	Recommended dosing frequency	Sample dose equivalency	Maximum total daily dose	Dose reduction
Beta-1 Selective
Acebutolol	BID	100mg BID	1,200mg	CrCl <50
Atenolol	Daily	50mg Daily	100mg	CrCl <35
Bisoprolol	Daily	5mg Daily	20mg	CrCl <40, cirrhosis, heart failure (10mg total daily)
Metoprolol IR	BID	50mg BID	400mg	Heart failure (200mg total daily)
Metoprolol SR	Daily	100mg Daily
Non-Selective
Carvedilol IR	BID	12.5mg BID	100mg	Weight <85kg, heart failure (50mg total daily), Contraindicated in severe liver impairment
Carvedilol ER	BID	40mg daily	80mg
Labetalol	BID-TID	100mg BID	2400mg
Nadolol	Daily	80mg Daily	320mg	CrCl <50
Pindolol	BID	5mg BID	60mg	Liver impairment
Propranolol IR	BID	40mg BID	640mg	Liver impairment
Propranolol ER	Daily	80mg Daily
Sotalol	BID	80mg BID	320mg	CrCl <60
Timolol	BID	5mg BID	60mg

*Disclaimer: These are not typical starting doses. Recommended starting doses depend on the clinical scenario.

 

Reference:

Pham P. Beta-blockers. Johns Hopkins Guides. September 26, 2013. Available

http://www.globalrph.com/beta_blockers.htm

Yancy 2013

Micromedex Comparison Tables: Beta Blockers. Last Modified: May 11, 2016.

Lexi-Comp, Inc. (Lexi-Drugs). Lexi-Comp, Inc.; April 10, 2018.