ACE Inhibitors (-pril)

Question 1

overall MOA of ACE inhibitors (aka ACEi)

Answer 1

• Block conversion of angiotensin I to angiotensin II
• Increase blood vessel vasodilation
• Increase bradykinin -> inc vasodilation
• Decrease aldosterone secretion -> dec Na+ and H2O retention

Question 2

ACEi indication

Answer 2

HTN, reduced ejection fraction heart failure (rEF-HF), post-MI, post-stroke, kidney disease

Question 3

ACEi AE

Answer 3

• Common: dry cough (20%), hypoTN/dizziness (10%), hyperkalemia (5%)
• Rare: acute renal failure, angioedema

Question 4

ACEi drug names to be familiar with

Answer 4

• Lisinopril
• Enalapril
• Ramipril

Question 5

therapeutic concerns about ACEi

Answer 5

Cough -> If pt is experiencing dry cough, discuss AE and possibly refer back to prescribing MD
NSAIDs -> Be aware of DDI b/w NSAIDs & ACEi (block bradykinin-mediated vasodilation -> impair effects of ACEi)