Hello dear all nursing students…
Thought to share with you the different categories of antihypertensive drugs in the simplest way (the way which I think would help in your exams). This topic is divided into various series under the headline – All about Antihypertensive Drugs Series… In this very first series, I will give you some notes on ACE inhibitors.
ACE INHIBITORS (prils suffix group)
These are the most widely prescribed Antihypertensive agents. This group includes the drugs with – pril suffix.
Examples of ACE inhibitors
- Captopril ( Capoten)
- Enalapril ( Vasotec)
- Lisinopril ( Zestril)
- Ramipril ( Tritace)
HOW ACE INHIBITORS ACT
* As the name indicates, the fundamental action of these drugs is the inhibition or blocking of Angiotensin Converting Enzyme, which is responsible for the convention of Angiotensin I to Angiotensin II in the Renin-Angiotensin-Aldosterone mechanism, thus prevent Aldosterone release and its effects.
ACE inhibitors ———-> prevent AT II production —-> results in
- No Aldosterone release
- Eliminate sodium ions
- Retain potassium ions
- Decrease peripheral arterial resistance
- overall, Decrease in BP and Blood Volume
INDICATIONS (When it is used)
* Hypertension – Primary use is to decrease BP
* Congestive Heart Failure (CHF) – In combination with diuretics and digitalis for the overall improvement of the patient
* Ischemic Heart Disease – To reduce the risk of attack and stroke
* Diabetic Nephropathy – prevents progression of Nephropathy
* Renovascular diseases
* Aortic stenosis
* Persistent dry cough
* Closely monitor BP before and in between the administration. Systolic BP should be maintained > 80 mm of Hg.
* obtain baseline vital signs and lab reports of CBC, LFT, RFT, electrolytes, prior to treatment.
* First dose Hypotension management- an Initial dose of ACE inhibitors has the risk of 1st dose Hypotension. So, advise the patient to sit or lie down for 2 – 4 hours after the first dose.
* Orthostatic Hypotension management- Advise the patient to rise and change the position very slowly
* Teach the importance of withholding of potassium-sparing diuretics and other potassium supplements
* Advise reporting any of the signs and symptoms of side effects
* Explain to the patient that taste loss is expected for 2-3 months, and if it persists to notify the physician
- First ACE inhibitor
- Only ACE inhibitor capable of passing Blood-Brain Barrier
- Cause false positive result for urine acetone
ACE INHIBITORS – FLASH CARDS