Ace inhibitors

Question 1

MOA of Angiotensin Converting Enzyme

Answer 1

Inhibit conversation of Angiotensin 1 to Angiotensin 2

Question 2

Indication of ACE inhibitors

Answer 2

HF
HTN
Diabetic Neuropathy
Prophylaxis of CV events

Question 3

Contraindication of ACE inhibitors

Answer 3

ACEi in combination with Aliskiren in patients with Diabetes mellitus and patients with egfr <60ml/min
Hereditary or idiopathic angioedema, hx of angioedema associated with prior ACE inhibitor therapy

Question 4

Caution with ACE i

Answer 4

Africans may respond less well
Concomitant diuretics
First dose hypotension ( esp with patient on high doses of diuretics, low sodium diet, on dialysis, dehydrated or with HF

Question 5

Uses of ACE inhibitors

Answer 5

Used in all grades of HF plus BB
Discontinue potassium sparing diuretics and potassium supplements before starting ACEi due to risk of hyperkalaemia

Question 6

Main side effects of ACE inhibitors

Answer 6

Alopecia
Persistent dry cough
Skin reactions
G.I
Angina pectoris
Angioedema (may be delayed ,more common in Afro- carribeans

Question 7

State when to discontinue ACE inhibitors

Answer 7

If marked elevation of hepatic enzyme or jaundice occur

Question 8

Cautions for ACE inhibitors

Answer 8

Avoid during dialysis to prevent anaphylatoid reactions
Avoid ACE inhibitors in pregnancy as it affects fetal and neonatal BP and renal function, skull defect reported

Question 9

Renal impairment with ACe inhibitors

Answer 9

Use with caution. Start with low dose and adjust according to response

Question 10

Monitoring requirements with ACE inhibitors

Answer 10

Renal function and electrolytes should be monitored

Question 11

Direction for Administration of ACE inhibitors

Answer 11

For HTN, first dose should preferably by given at bedtime