ACE Inhibitors

Question 1

MOA

Prevents angiotensin I from converting to angiotensin II, a potent vasoconstrictor

Vasodilation causes drop in BP

Answer 1

Lack of angiotensin II prevents secretion of aldosterone (reabsorption of sodium & water)

Lack of aldosterone allows diuresis of sodium & water

Question 2

Contraindications/precautions

• Hyperkalemia, kidney dz, allergy

Question 3

Drug interactions

• Inc effects w/other anti-hypertensives & diuretics
• Lithium toxicity w/lithium & hyperkalemia w/supplements

Question 4

Adverse effects

• HA, dry non-productive cough
• Fatigue, dizziness, pruritus
• Anemia, neutropenia, thrombocytosis, agranulocytosis

Answer 4

• Hyperkalemia, rash, proteinuria
• Mood changes, loss of taste, angioedema

Question 5

Nursing

! Do not stop abruptly
* Apical pulse & BP prior to admin

• Possible anorexia r/t loss of taste
• Postural hypotension

Answer 5

! Do not use w/K+ supplements

• Hold if K+ >5 mEq/L
• Lozenges for cough

Question 6

Examples

• Captopril
• Enalapril