Ace Inhibitors

Question 1

What is the action of ACE inhibitors?

Answer 1

block ACE from converting Angiotensin I to Angiotensin II; in the lungs

Question 2

ACE inhibitors drug names?

Hint: end in “pril”

Answer 2

Benazepril
Captopril
Enalapril
Lisinopril
Ramipril

Question 3

What are the contraindications for ACE inhibitors?

Answer 3

Allergy
impaired renal function
(↓renal blood flow; make kidneys worse)
Pregnancy- black box warning (known to cause fetal abnormalities)

Question 4

What are the cautions for ACE inhibitors?

Answer 4

Acute/unstable CHF

African Americans

Question 5

Drug-Drug Interaction (DDI) for ACE inhibitors?

Answer 5

Aliopurinol- used for gout
↑ risk of hypersensitivity reaction
Drugs that affect RAAS (ARBS & Renin)
NSAIDs
↓ ACE inhibitor effectiveness

Question 6

What are the indications for ACE inhibitors?

Answer 6

HTN
CHF (↓ blood volume, peripheral resistance, & cardiac workload)
Left ventricular dysfunction
Diabetic nephropathy prevention

Question 7

What are the adverse effects of ACE inhibitors related to vasodilation and alterations in blood flow?

Answer 7

Reflex tachycardia
(have low BP and body tries to ↑ HR to compensate)
Hypotension
Renal insufficiency
Dizziness
Fatigue
Erectile dysfunction

Question 8

What are the adverse effects of ACE inhibitors due to other things?

Answer 8

Pancytopenia (due to the depression of bone marrow)
GI irritation (nausea, vomiting, abdominal pain)
Rash (skin)
Hyperkalemia (lose water & sodium; ↑ in potassium)
Cough

Question 9

At what range is considered to be an elevated blood pressure?

Answer 9

120/80

Question 10

What are the nursing implications?

Answer 10

Give on empty stomach
CBC- check for pancytopenia
Educate pt on cough (after stopping medication cough can persist until a month after)
Ineffective tissue perfussion
Use contraceptives