ACE-1, Antihypertensive

Question 1

Benazepril —– Brand name, class and dosage forms?

Answer 1

Brand name: Lotensin
Class: ACE-I, Antihypertensive
Dosage forms: oral tablet (5, 10, 20, 40mg)

Question 2

Benazepril —– Indication?

Answer 2

Hypertension

Question 3

Benazepril —– MOA?

Answer 3

Competitive ACE-I; It also reduces serum aldosterone, leading to decreased sodium retention, potentiates the vasodilator kallikrein–kinin system, and can alter prostanoid metabolism, inhibit the sympathetic nervous system, and inhibit the tissue renin-angiotensin system.

Question 4

Benazepril—– contraindication?

Answer 4

hypersensitivity, history of angioedema, anuria, concomitant use with aliskiren in pt with DM, concurrent sacubitrul

Question 5

Benazepril—–efficacy monitoring parameters?

Answer 5

Decreased BP

Question 6

Benazepril—- key patient counseling points?

Answer 6

Avoid in pregnancy
Seek immediate medically attention if you experience an facial swelling
most common adverse effect is a dry cough
use potassium supplements or salt substitutes under under medical supervision
may cause dizziness (worsens with dehydration)
take at the same time everyday

Question 7

Benazepril—– ADR?

Answer 7

Common: none

Less common: Diarrhea, orthostatic dizziness, dry cough, fatigue, headache, hyperkalemia, nausea, nephrotoxicity, rash, tachycardia, vomiting

serious: angioedema (facial swelling), birth defects, liver failure, stevens-Johnson syndrome

Question 8

Enalapril —– Brand name, class, and dosage forms?

Answer 8

Brand name: Vasotec
Class: ACEI, antihypertensive
Dosage form: oral tablet and oral solution

Question 9

Enalapril —– indications?

Answer 9

Heart failure
HTN
Kidney disease (non-DM)

Question 10

Enalapril—- MOA?

Answer 10

prodrug that is rapidly converted to its active metabolite, enalaprilat, a competitive ACEI. It reduces serum aldosterone, leading to decreased sodium retention, potentiates the vasodilator kallikrein–kinin system, and inhibits the sympathetic nervous system and tissue renin-angiotensin system. The net effect is reduction in total peripheral resistance and BP in hypertensive patients and reduction in elevated afterload in patients with heart failure.

Question 11

Enalapril —– Contraindications?

Answer 11

hypersensitivity to enalapril, history of angioedema, pregnancy, concurrent sacubitril

Question 12

Enalapril —–ADR?

Answer 12

common: increased SCr

Less common: diarrhea, dizziness, dry cough, fatigue, headache, hypotension, hyperkalemia, nausea, nephrotoxicity, rash, tachycardia

serious: angioedmea, birth defects and liver failure

Question 13

Enalapril —–efficacy monitoring parameters?

Answer 13

decreased BP, signs of heart failure

Question 14

enalapril —- toxicity monitoring parameters

Answer 14

signs of angioedema, severe persistent cough, hypotension, monitor baseline and periodic electrolytes, SCr, BUN, and urine protein

Question 15

enalapril—– key patient counseling points?

Answer 15

Use potassium supplements or salt substitutes only under medical supervision. Report signs/symptoms of angioedema. May cause dizziness that may worsen if dehydrated. Use caution rising from sitting or lying position, especially when initiating treatment.

Question 16

Lisinopril—– brand name, dosage form, and class

Answer 16

brand name: Prinivil and Zestril
class: ACEI, antihypertensive
dosage form: oral tablet (2.5, 5, 10,20, 30, 40) and oral solution

Question 17

lisinopril—–indications?

Answer 17

ST-segment elevation MI

Heart failure with reduced ejection fraction

HTN

Question 18

Lisinopril ——- MOA?

Answer 18

Lisinopril is a competitive ACEI. It also reduces serum aldosterone, leading to decreased sodium retention, potentiates the vasodilator kallikrein–kinin system, and can alter prostanoid metabolism, inhibit the sympathetic nervous system, and inhibit the tissue renin-angiotensin system.

Question 19

lisinopril —– contraindications?

Answer 19

Hypersensitivity to lisinopril or other ACEIs, history of ACEI-induced angioedema, and hereditary or idiopathic angioedema, concurrent use with aliskiren in diabetic patients, concurrent use with sacubitril

Question 20

lisinopril —– ADR?

Answer 20

common: none known

less common: Diarrhea, dizziness, dry cough, headache, hypotension, hyperkalemia, nausea, nephrotoxicity, rash, tachycardia, vomiting

serious: angioedmea, birth defects, liver failure

Question 21

Lisinopril—— monitoring?

Answer 21

efficacy- decreased BP

toxicity- Signs/symptoms of angioedema (swelling of the face, eyes, lips, tongue, or throat), severe persistent cough, hypotension; monitor baseline and periodic electrolytes, SCr, BUN, and urine protein.

Question 22

Lisinopril ——key counseling points?

Answer 22

Avoid pregnancy. Use potassium supplements or salt substitutes only under medical supervision. May cause dizziness that may worsen if dehydrated.

**can be considered first line agent for HTN management in pt with PMH of DM, or HF w/ reduced ejection fraction

Question 23

Quinapril—— brand name, class, and dosage form?

Answer 23

Brand name: Accupril
class: ACEI, antirhypertensive
dosage form: oral tablet

Question 24

Quinapril—-Indications?

Answer 24

heart failure and HTN

Question 25

Quinapril —- MOA?

Answer 25

competitive ACEI that prevents the conversion of angiotensin 1 to angiotensin II which is a vasoconstrictor; Also reduces aldosterone leading to decreased sodium retention, potentiates the vasodilator kallikrein–kinin system and alters prostanoid metabolism, and inhibits sympathetic nervous system and the tissue renin-angiotensin system.

Question 26

Quniapril —- contraindications?

Answer 26

hypersensitivity to quinapril or other ACEI, history of ACEI-induced angioedmea, concurrent sacubitril

Question 27

Quinapril ——- ADR?

Answer 27

common: nausea

Less common: diarrhea, dizziness, dry cough, fatigue, headache, hypotension, hyperkalemia, nephrotoxicity, rash, tachycardia, vomiting

serious: angioedema, birth defects, liver failure

Question 28

Quinapril —– Monitoring and key counseling points?

Answer 28

efficacy: BP and signs/symptoms of heart failure
toxicity: Signs/symptoms of angioedema, persistent dry cough, hypotension; monitor baseline and periodic electrolytes, SCr, BUN, urine protein.

key patient counseling points: Avoid pregnancy. Avoid sudden discontinuation; rebound HTN can occur. Use potassium supplements or salt substitutes only under medical supervision. May cause dizziness that may worsen if dehydrated.

Question 29

Ramipril —– brand name, dosage form, class

Answer 29

brand name: altace
class: ACEI, antihypertensive
dosage form: oral capsule

Question 30

Ramipril —- indications?

Answer 30

heart failure post-MI
HTN
Reduce risk of myocardial infarction, stroke, and death from CV causes

Question 31

Ramipril —— MOA?

Answer 31

Ramipril is a competitive ACEI. It is also a prodrug for the more potent ACEI ramiprilat. ACEI prevents conversion of angiotensin I to angiotensin II (a vasoconstrictor). It also reduces serum aldosterone, leading to decreased sodium retention, potentiates the vasodilator kallikrein–kinin system, and inhibits the tissue renin-angiotensin system.

Question 32

Ramipril —– contraindications?

Answer 32

Hypersensitivity to ramipril or other ACEIs, history of ACEI-induced angioedema; concurrent sacubitril

Question 33

Ramipril —– ADR?

Answer 33

Common: none

Less Serious: Diarrhea, dizziness, dry cough, headache, hypotension, hyperkalemia, nausea, nephrotoxicity, rash, tachycardia, vomiting

Serious: Angioedema, birth defects, liver failure

Question 34

Ramipril —– Monitoring?

Answer 34

Efficacy : BP, progression of heart failure

Toxicity: Angioedema (swelling of the face, eyes, lips, tongue, or throat), persistent dry cough, hypotension; baseline and periodic potassium, SCr, BUN, and urine protein

Question 35

Fosinopril ——- Brand name, dosage form, class

Answer 35

Brand name: Monopril
Dosage form: oral tablet
Class: ACEI, antihypertensive

Question 36

Fosinopril —– indication?

Answer 36

Heart failure and HTN

Question 37

Fosinopril ——– MOA?

Answer 37

Fosinopril is a competitive ACEI. It also reduces serum aldosterone, leading to decreased sodium retention, potentiates the vasodilator kallikrein–kinin system, and can alter prostanoid metabolism, inhibit the sympathetic nervous system, and inhibit the tissue renin–angiotensin system.

Question 38

Fosinopril —— contraindication?

Answer 38

Hypersensitivity, history of ACEI-induced angioedema, and hereditary or idiopathic angioedema, concomitant use with aliskiren in patients with diabetes

Question 39

Fosinopril —— ADR?

Answer 39

Common: Dizziness

Less Serious: Diarrhea, dry cough, headache, hypotension, hyperkalemia, nausea, nephrotoxicity, rash, tachycardia, vomiting

Serious: Angioedema, birth defects, liver failure