ACE Inhibitors

Question 1

Captopril / Ramipril / Lisinopril
MOA

Answer 1

Lower blood pressure by decreasing vasoconstriction and plasma volume. Inhibits angiotensin-converting enzyme thus reducing the synthesis of vasoconstrictor angiotensin II.
This decreases aldosterone secretion, resulting in increased salt and water excretion, indirectly
decreasing plasma volume and cardiac load

Question 2

Captopril / Ramipril / Lisinopril
Abs/Distrb/Elim

Answer 2

Orally
Captopril: half-life ~2h.
Lisinopril: half-life 12h.
Ramipril (prodrug) active metabolite ~ 11h

Question 3

Captopril / Ramipril / Lisinopril
Clinical use

Answer 3

Hypertension
Heart failure
MI

Question 4

Captopril / Ramipril / Lisinopril
Adverse effects

Answer 4

Increased bradykinin, dry cough
Hypotension on initial doses
Reversible renal impairment
Hyperkalemia (if taken with potassium sparing diuretics)