ACE inhibitors

Question 1

What are ACE inhibitors?

Answer 1

Block angiotensin I being converted to angiotenin II

Question 2

What are they indicated in?

Answer 2

Hypertension, HF, and diabetic nephropathy, prophylaxis of CVS events (RENAL AND CARDIO PROTECTIVE)

Question 3

What is the main side effect?

Answer 3

Hyperkalaemia and persistent dry cough

Question 4

Why does someone on an ACE have a dry cough?

Answer 4

inhibits breakdown of bradykinin and other kinins and so can cause a persistent dry coughs

Question 5

What are angiotensin- II receptor antagonists?

Answer 5

Losartan, candesartan, irbesartan etc. These dont inhibit the breakdown of bradykinin so are a useful alternative to ACE inhibitors

Question 6

What are the targets and aims for chronic HF?

Answer 6

1. Improve exercise tolerance
2. reduce incidences of exacerbation
3. Reduce mortality
4. ACE and BB can both be beneficial in patients with chronic HF
   (if uncontrolled HF, no BB)

Question 7

What are renin-inhibitors?

Answer 7

blocks angiotensinogen to angiotensinogen I

Aliskerin