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Heiman.pharm.HTN.4

ACE Inhibitors

QuestionAnswer
Mechanism Inhibit the conversion of angiotensin I to angiotensin II. Angiotensin II is a potent vasoconstrictor. Reduced angiotensin II results in increased plasma renin which leads to decreased aldosterone secretion.
Mechanism con'td Decreased Na and H2O retention. Prevents breakdown of bradykinin. Bradykinin is a potent vasodilator.
Effects Decreased systemic vascular resistance No changes in heart rate Increased renal perfusion Renal vascular resistance decreased Prevention of ventricular remodeling Takes up to four weeks to get full antihypertensive effect
Kinetics Relatively low bioavailability Large first past effect Variable protein binding Most are prodrugs Need to be metabolized in the liver to be active Renal excretion
Adverse Effects Rash Cough Orthostatic hypotension Nausea Diarrhea, constipation Leukopenia Myalgia Headache Hyperkalemia Angioedema Photosensitivity
Drug Interactions Increased levels of other drugs Digoxin Lithium Potassium Decreased levels of ACE inhibitors Antacids, indomethacin Potassium-sparing diuretics, potassium supplements
Cautions Renal insufficiency Decrease dose Liver disease No activation from pro – drug Captopril and moexipril need to be taken on an empty stomach
Names Captopril (Capoten)‏ Lisinopril (Zestril, Prinivil)‏ Benazepril (Lotensin)‏ Enalapril (Vasotec)‏ Quinapril (Accupril)‏ Moexipril (Univasc)‏
Names Ramipril (Altace)‏ Trandolapril (Mavik)‏ Fosinopril (Monopril) Perindopril (Aceon)‏ Also in combination with thiazides and other antihypertensives
Created by: DianaB
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