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N112 ACE Inhibitors

N112 - ACE Inhibitors for test 1

QuestionAnswer
ACE Inhibitors Angiotensin Converting Enzyme Inhibitors, prevents Angiotension I from converting to Angiotesnin II
Uses Used alone or with other medication to treat HTN (hypertension)
Other uses Adjunctive therapy for CHF (congestive heart failure), Nephroprotective effects, reduces pressure in the kidneys
RAAS action Suppresses RAAS (renin angiotensin aldosterone system), block the enzyme that converts angiotensin I to angiotensin II (potent vasoconstrictor & stimulator for aldosterone), decreases PVR (peripheral vascular resistance)/afterload
Bradykinin Action inhibits breakdown of bradykinin (which has vasodilating properties) = decreases PVR/afterload
Aldosterone Action inhibits aldosterone secretion (Na+ and H2O are not retained) = dieresis
CHF Action inhibits aldosterone secretion & therefore prevents Na+ & H2O reabsorption and it also decreases PVR and improves cardiac output
Side effects/Adverse reactions Dry, nonproductive cough, hypotensive effect, hyperkalemia (increased K+), headache, dizziness, altered sense of taste, angioedema
Dry, hacking cough reversible with discontinuation, thought to come from accumulation of Bradykinin
Dizziness/hypotensive effect can cause 1st dose sincopy, or fainting
Nursing consideration 1 monitor vital signs, especially BP, monitor K+ (potassium) levels
Nursing consideration 2 teach patient to take 1 or 2 hours after meals and to not stop the drug abruptly, could cause rapid increase in BP
Nursing consideration 3 teach patient to change position slowly to avoid orthostatic hypotension
Evaluate effectiveness of the drug Decreased BP, Improvement in S/S of CHF, decreased renal damage
Drug to drug interaction NSAIDs = decrease the effect of ACE inhibitors, Lithium = Lithium toxicity
Created by: jrb265