ACE INHIBITORS ANGIOTENSIIN-CONVERTING ENZYME INHIBITORS Flashcards
Angiotensin-Coverting Enzyme Inhibitors are called what?
( ACE) inhibitors)
What is the expected pharmacological action of an ACE inhibitor?
It reduces production of angiotensin 2 by blocking the conversion of angiotensin 1 to angiotensin 2
also vasodilation, excretion of sodium (Na) and water, and retention of potassium by actions of the kidneys
What is angiotensin?
A protein whose presence in the blood promotes aldosterone secretion & tends to raise the blood pressure
What are conditions or therapeutic uses for an ACE?
1) HTN, 2) HF, 3) Myocardial Infarction (MI) - to decrease mortality and to decrease the risk of heart failure & LV dysfunction 4) Diabetic and nondiabetic neuropathy 5) For clients at risk for a CV event
What is the ACE of choice used to prevent MI Stroke or death?
Ramipril
***** Most all ACE inhibitors drugs end in the letters RIL
Catopril, Enalapril, Lisinopril Ramipril, Moexipril, Benazepril
Complications for a first dose *****
If a patient is already taking a diuretic, stop the medication temporarily for 2–3 days prior to starting an ACE inhibitor, ** Taking another hypertensive medication increases the effects of an ACE Start treatment with a low dose, Monitor B/P for 2 hours after initiation of treatment,
What are important client education points when taking an ACE?
Instruct clients to change positions slowly and lie down if they are dizzy, lightheaded or faint, inform patients of the possibility of a dry cough & to notify the physician, Avoid the use of salt substitutes (they contain potassium)
Other complications or adverse effects of an ACE Inhibitor
Hyperkalemia, rash & dysgeusia (altered taste) Angioedema Neutropenia (a rare but serious complication of captopril
What is the serum potassium levels?
3.5-5.0
While taking Captopril what blood test will the physician order to assess for neutropenia?
WBC count every 2 weeks for 3 months.
What are the contraindications for an ACE?
Pregnancy, bilateral renal artery stenosis, or clients who have a single kidney, or have a kidney or vascular disease because they are more at risk for neutropenia
What are the drug interactions?
Diuretics, Antihypertensive Rxs, K supplement & K sparing diuretics, ACE inhibitors can increase levels of lithium, NSAID can decrease the antihypertensive effect.
What is the route of administration?
Orally except Enalaprilat which is the only ACE for IV use
Administer which ACE inhibitors at least 1 hour before meals (2) ?
Take Captopril & Moexipril at least 1 hour before meals -*** other ACE drugs are taken with or without food
