ACE Inhibitors Flashcards
1
Q
Drugs that are ACE Inhibitors
A
Prototype: Captopril (Capoten)
Other: Enalpril (Vasotec)
Fosinopril (Monopril)
Lisinopril (Prinivil)
2
Q
Expected Pharmacologic Action
A
Blocks production of angiotensin II.
- Vasodilation (arteriolar)
- Urinary excretion of Na and H20
- Urinary retention of potassium.
3
Q
Side and Adverse Effects
A
- Severe hypotension following first dose.
- Dry, nonproductive cough due to increase in bradykinin.
- Angioedema (swelling of mouth)
- Rash & report of metallic taste in mouth.
- Hyperkalemia
- Neutropenia
4
Q
Intervention
A
- Start with lose does; gradually increase.
- Monitor for angioedema; treat with IV epinephrine
- Monitor potassium levels and WBC counts.
- Monitor blood pressure closely with first dose.
5
Q
Administration
A
- Available for oral use only.
- 2-3 x’s daily for hypertension
- 3x’s daily for HF.
- Captopril 1hr before meals for adequate absorption.
6
Q
Patient Instruction
A
- Be are that hypotension may occur.
- Report dry cough, rash, taste in mouth.
- Report minor swelling of mouth, throat; call 911 immediately if severe.
- Refrain from using potassium supplements and potassium-containing salt.
- Do not take, if your are pregnant or breast feeding.
7
Q
Contraindication
A
- Pregnancy risk category D, lactation
- Angoedema or allergy to ACE inhibitors
- Hypotension
- Liver disease with elevated liver enzymes.
8
Q
Precautions
A
- Decreased renal function
- Bone marrow depression or use of immunosuppressing drugs
- Autoimmune disorders
- Cardovascular disease
- Cerebral vascular disease
- Heart failure
- Hyperkalemia and hyponatremia
9
Q
Interactions
A
- Potassium-sparing diuretics
- Antihypertensive drugs, nitrates, diuretics increase risk for hypotension.
- NSAIDs may decrease effectiveness
- Food decreases absorption of captopril
- ACE inhibitors may cause lithium toxicity.
