Ace Inhibitors

Question 1

Ace Inhibitor Drug names

Answer 1

Benazepril
Captopril
Enalapril
Lisinopril
Ramipril

“-pril”

Question 2

Ace Inhibitor therapeutic actions

Answer 2

• Blocks ACE from converting angiotensin I to angiotensin II in the RAAS.
• Blocks aldosterone leading to vasodilation, sodium and water excretion, and small increase in serum potassium.

Question 3

Ace inhibitor Indications

Answer 3

• HTN
• CHF and left ventricular dysfunction (in conjunction with other medications)
• Diabetic nephropathy prevention.

Question 4

Ace Inhibitor contraindications and cautions

Answer 4

Contraindication:
• Allergy
• Impaired renal function
• Pregnancy- black box warning

Caution:
• Acute/unstable CHF
• African Americans

Question 5

Ace Inhibitor DDI

Answer 5

• Allopurinol
• Other drugs affecting RAAS
• NSAIDs

Question 6

Ace Inhibitor Adverse effects

Answer 6

• Reflex tachycardia
• Hypotension *
• Renal insufficiency
• Dizziness
• Fatigue
• Erectile dysfunction
• Pancytopenia (depression of bone marrow)
• GI irritation
• Rash
• Hyperkalemia
• Cough (dry constant) 30% of patients get it, can take a month to get over once stopping.

Question 7

Ace Inhibitors:

Assessment

Answer 7

Hx: allergy, contra/cautions, pregnancy
Physical: vital signs, weight, cardiac respiratory, abdominal, skin (baseline)
Labs: renal functions, electrolytes, pregnancy test, CBC

Question 8

Ace Inhibitor:

Diagnosis

Answer 8

• Ineffective tissue perfusion
• Admission on empty stomach
• Patient teaching regarding cough
• Impaired skin integrity
• Acute pain
• Deficient knowledge

Question 9

Ace Inhibitor:

Implementation

Answer 9

• Encourage lifestyle changes
• Use of barrier contraceptives
• Monitor the patient carefully in any situation that might lead to a drop in fluid volume
• Provide throughout patient teaching

Question 10

Ace Inhibitor:

Evaluation

Answer 10

Response to the drug (weight, electrolytes, blood pressure, EKG)

Adverse effects (hypotension, fatigue, dry cough, hyperkalemia, reflex tachycardia)

Effectiveness of comfort measures Compliance with the regimen

Effectiveness of the teaching plan