ACEi Flashcards
What are the possible uses of ACEi?
Younger patients with hypertension
Heart failure
Diabetic nephropathy
Secondary prevention of ischaemic heart disease
What is the mechaism of action of ACEi?
Inhibit the conversion angiotensin I to angiotensin II
Where are ACEi activated?
Phase 1 metabolism in the liver
What are the possible side effects of ACEi?
Cough
Angioedema
Hyperkalaemia
First dose hypotension
What electrolyte disturbance can ACEi cause?
Hyperkalaemia
What are the possible contraindications od ACEI?
Pregnancy
Aortic stenosis
Renovascular disease
What interaction can occur with ACEi?
High dose diuretics
(80mg of furosemide)
What is classed as high dose diuretic?
80mg of furosemide
What needs to be monitored in someone on ACEi?
Urea and electrolytes
When do urea and electrolytes need to be monitored in someone on ACEi?
Before treatment is initiated
After increasing the dose
What should be expected after starting on an ACEi?
A rise in the creatinine and potassium
What is classed as an acceptable rise in creatinine?
Increase in serum creatinine, up to 30% from baseline
What is classed as an acceptable rise in potassium?
An increase in potassium up to 5.5 mmol/l.
When might significant renal impairment occur after starting someone on an ACEi?
Undiagnosed bilateral renal artery stenosis
