All About Antihypertensive Drugs Series-1-ACE INHIBITORS

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

  1. Captopril ( Capoten)
  2. Enalapril ( Vasotec)
  3. Lisinopril ( Zestril)
  4. 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

  1. No Aldosterone release
  2. Eliminate sodium ions
  3. Retain potassium ions
  4. Decrease peripheral arterial resistance
  5. 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

CONTRAINDICATIONS

*Hypersensitivity

* Pregnancy

* Renovascular diseases

* Aortic stenosis

SIDE EFFECTS

* Hypotension

* Persistent dry cough

* Nausea

* Hyperkalemia

NURSING CONSIDERATIONS

* 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

BONUS NOTES

CAPTOPRIL

  • First ACE inhibitor
  • Only ACE inhibitor capable of passing Blood-Brain Barrier
  • Cause false positive result for urine acetone

ACE INHIBITORS – FLASH CARDS 

ACE Inhibitors Effects

DRUGS OF APRIL

INDICATIONS

CONTRAINDICATION

ACE Inhibitors NURSING considerations

 

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