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N112 ACE Inhibitors
N112 - ACE Inhibitors for test 1
Question | Answer |
---|---|
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 |