Mechanism of Action of ACE Inhibitors
- ACE Inhibitors completely inhibit angiotensin converting enzyme (ACE) resulting in decreased synthesis of angiotensin II, one of the most potent vasoconstrictors known.
- The reduction in Angiotensin II also decreases the release of Aldosterone thereby decreasing water and sodium reabsorption and lowers plasma volume.
- ACE Inhibitors also prevent the break down of bradykinin (a vasodilator)
FDA Indication of ACE Inhibitors
- Heart Failure (Adjunct Therapy)
- Acute Myocardial Infarction
Most Common Adverse Effects of ACE Inhibitors
- Chest Pain
- Syncope (fainting due to drop in BP)
RARE: Cough and Angioedema
What is the Pregnancy Category of ACE Inhibitors?
Pregnancy Category D
BBW of ACE Inhibitors
Use in pregnancy can harm fetus
ACE Inhibitors should avoided in renal impairment, ________ and patients with ________ ______ _________ ________.
2. Bilateral renal artery stenosis
Patient Counseling Tips
Patients should be counseled that ACE Inhibitors can cause ________ _________ if taken while pregnant.
While on ACE Inhibitors women in child-bearing ages should use _________ ________.
Patients on ACE Inhibitors should be counseled that these medications can increase the amount of ________ in the body.
NOTE: Patients should be encouraged to not use potassium supplements or salt substitutes unless advised by PCP.
Patients on ACE Inhibitors should be advised to get emergency help if they experience the following symptoms signifying an allergic reaction:
- Swelling of the lips/face/tongue/throat
- Difficulty breathing
Patients on ACE Inhibitors should be informed that they can develop a dry, hacking ________.
NOTE: Patients should notify PCP if this happens