ACE inhibitors

Question 1

benazepril (Lotensin)

Answer 1

Purpose: treatment of hypertension
Side Effects: angioedema, cough, headache, dizziness, fatigue, hyperkalemia, nausea, vomiting, constipation, hepatotoxicity, increased renal lab values
Nursing consideration:
- Often used in combination with thiazide diuretics
- Avoid salt substitutes containing potassium because
of the potassium-sparing effect
- Avoid nonprescription cough medications unless the provider directed

Question 2

captopril

Answer 2

Purpose: treatment of hypertension, CHF, left ventricular dysfunction after MI and diabetic nephropathy
Side effects: bronchospasm, dyspnea, cough, orthostatic hypotension, dizziness, loss of taste, nephrotic syndrome, bone marrow suppression, hyperkalemia
Nursing consideration:
- Contact provider if fever, skin rahs, sore throat, mouth sores, swelling of hands or feet, fast or irregular heartbeat, chest pain, or cough
- Take on empty stomach 1 hour before meals or 2 hours after. tablets may be crushed and mixed with juice or soft food for ease of swallowing
- Avoid changing postion rapidly esp during the first few dyas
- Do not use OTC meds unless directed
- Avoid salt substitutes containing potassium because
of the potassium-sparing effect

Question 3

enalapril (Vasotec)

Answer 3

Purpose: treatment of hypertension, CHF and left ventricular dysfunction
Side effects: HA, dizziness, hypotension, tachycardia, dysrhythmias, tinnitus, hyperkalemia, angioedema, persistent cough, insomnia, bone marrow suppression, hepatotoxiity, renal failure
Nursing considerations:
- Contact provider if fever, skin rahs, sore throat, mouth sores, swelling of hands or feet, fast or irregular heartbeat, chest pain, or cough
- Avoid changing postion rapidly esp during the first few days
- Do not use OTC meds unless directed
- Avoid salt substitutes containing potassium because
of the potassium-sparing effect
- May be crushed: give without regard to food

Question 4

lisinopril (Prinivil, Zestril)

Answer 4

Purpose: treatment of mild to moderate HTN, adjunctive therapy for systolic CHF and acute MI
Side Effects: HA, fatigue, dizziness, vertigo, n/v/d, hypotension, tachycardia, cough, renal insufficiency, hepatic failure, hyperkalemia
Nursing consideration:
- Avoid changing postion rapidly esp during the first few days
- May take without regard to food
- Avoid salt substitutes containing potassium because
of the potassium-sparing effect

Question 5

ramipril (Altace)

Answer 5

Purpose: Treatment of HTN and CHF following MI; prophylactic risk reduction of MI, stroke, and death from cardiovascular disorder
Side Effects: HA, fatigue, hypotension, dizziness, vertigo, n/v/d, cough, hyperkalemia, altered renal and hepatic function tests, decreased Hgb and Hct
Nursing Consideration:
- Can mix capsule contents with water, juice, or applesauce to aid swallowing
- Avoid changing positions rapidly
- Contact provider if persistent dry, nonproductive cough; increased SOB; edema’ or unusual bruising or bleeding
- Avoid salt substitutes containing potassium because
of the potassium-sparing effect