angiotensin converting enzyme (ace) inhibitors

Question 1

Indications of ACE inhibitors?

Answer 1

hypertension, heart failure

Question 2

Contraindications of ACE inhibitors?

Answer 2

combination with aliskiren in patients with poor renal function or diabetes, renal artery stenosis

Question 3

Mechanism of action of ACE inhibitors

Answer 3

works by blocking the renin-angiotensin-aldosterone system which inhibits the conversion of angiotensin I to angiotensin II. this leads to arterial vasodilation, reduced aldosterone secretion and reduction in blood pressure. prevents left ventricular remodelling following a heart attack

Question 4

Common side effects of ACE inhibitors

Answer 4

dry cough, headache, dizziness, nausea, vomiting, diarrhoea, hypotension, chest pain, drowsiness, abdominal discomfort

Question 5

Monitoring requirements for ACE inhibitors

Answer 5

renal function and electrolytes (particularly potassium) should be checked before starting ACE inhibitors and monitored during treatment. blood pressure should be monitored at first in case of initial drops

Question 6

Treatment cessation of ACE inhibitors

Answer 6

none

Question 7

Patient and carer advice for ACE inhibitors

Answer 7

should not be initiated during pregnancy. patients should be warned of persistent cough, newer generation ACE I’s have less of this effect. initial use can lead to sudden blood pressure drops, patients new to the medication should be successfully monitored