ace inhibitors

Question 1

MOA

Answer 1

Competitive inhibitor of angiotensin-converting enzyme (ACE); prevents conversion of angiotensin I to angiotensin II, a potent vasoconstrictor; results in lower levels of angiotensin II which causes an increase in plasma renin activity and a reduction in aldosterone secretion

Question 2

Drug names

Answer 2

• Benazepril
• Captopril
• Enalapril
• Fosinopril
• Lisinopril
• Moexipril
• Perindopril
• Quinapril
• Ramipril
• Trandolapril

Question 3

indication

Answer 3

• Heart failure (enalapril)
• Heart failure- post MI (ramipril, trandolapril)
• Post-MI (captopril)
• High coronary disease risk (ramipril, perindopril)
• DM (captopril)
• CKD (captopril, ramipril)
• Stroke (perindopril, indapamide)

Question 4

Adverse effect

Answer 4

• Cough (dry)
• Hyperkalemia
• Increase in sCr (<35% acceptable)
• Angioedema
• Hypotension/syncope

Question 5

monitoring

Answer 5

• Electrolytes (K)
• Renal function (sCr, BUN)
• 7-14 days after initiation/dose change

Question 6

comment

Answer 6

• Should not combine ACEI + ARB  more serious ADRs
Contraindication:
• pregnancy
• hypersensitivity (angioedema)
• Bilateral renal artery stenosis/unilateral renal artery stenosis in a solitary functional kidney
• K >5.5 that cannot be reduced