ANGIOTENSIN-CONVERTING ENZYME (ACE) INHIBITORS

what are names of ACE inhibitors?

• suffix - pril

  • captopril

  • enalapril

  • lisinopril

  • ramipril

what is the mechanism of action for ACE inhibitors?

• inhibit RAAS

• block the Angiotensin-Converting Enzyme

  • promotes vasodilation and decreases aldosterone and then lowers BP

  • promotes water excretion

• inhibits breakdown of bradykinin leading to an increase in bradykinin and vasodilation, bronchoconstriction (cough), angioedema (rare)

what is the indication for ACE inhibitors?

cardiovacular and renal conditions

• hypertension

  • vasodilation and water excretion

• heart failure

• myocardial infarction (MI)

• Chronic kidney disease

• diabetic nephropathy

what are adverse effects of ACE inhibitors?

Think “ACTOR-P”

• Angioedema (rare)

• Cough (dry, persistent, nonproductive)

• Teratogenic effects

• Orthostatic hypotension

• Renal insufficiency

• Potassium elevated (hyperkalemia)

what are nursing interventions for ACE inhibitors?

• reduce potassium intake (salt substitutes)

• rise slow when changing positions

• monitor BP

• monitor and report edema of tongue, lips, eyes

• notify HCP if cough becomes bothersome

• avoid NSAIDS bc they vasocontrict

• never take ARBs with ACE inhibitors