Ace inhibitors pdf nikhil
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ACE inhibitors are a class of pharmaceutical drugs used to treat hypertension and congestive heart failure. They work by inhibiting the angiotensin-converting enzyme, which decreases the production of angiotensin II and lowers blood pressure. Some common ACE inhibitors discussed in the document include captopril, enalapril, lisinopril, and benazepril. Nursing considerations for ACE inhibitors include monitoring for hypotension, changes in renal function, and hyperkalemia.
Ace inhibitors pdf nikhil
- 1. ACE INHIBITORS An angiotensin-converting-enzyme inhibitor is a pharmaceutical drug used primarily for the treatment of hypertension and congestive heart failure. Angiotensin converting enzyme inhibitors (ACE inhibitors) are medications that slow (inhibit) the activity of the enzyme ACE, which decreases the production of angiotensin II. They inhibit the angiotensin-converting enzyme, an important component of the renin–angiotensin system.
- 2. CLASSIFICATION OF ACE INHIBITORS Sulfhydryl-containing agents: Captopril , the first ACE inhibitor Dicarboxylate-containing agents: Enalapril, Ramipril, Quinapril, Perindopril, Lisinopril, Benazepril. Phosphonate-containing agents: Fosinopril
- 3. INDICATIONS High blood pressure Coronary artery disease Heart failure Diabetes Certain chronic kidney diseases Heart attacks Scleroderma Migraines
- 6. CAPTOPRIL • Trade name: Capoten • Drug availability: CAPOTEN is available in potencies of 12.5 mg, 25 mg, 50 mg, and 100 mg as scored tablets for oral administration. • Action: Blocks ACE from converting angiotensin I to angiotensin II . It is a powerful vasoconstrictor , leading to decreased BP, decreased aldosterone secretion, a small increase in serum potassium levels, and sodium and water loss.
- 7. • Indications: Hypertension, Heart Failure, Left Ventricular Dysfunction After Myocardial Infarction, Diabetic Nephropathy. • Contraindications: allergic to ACE inhibitors, pregnancy. • Side effects: Fever, chest pain, arthralgia, cough, pruritis, cough, dysuria, angioedema.
- 8. NURSING CONSIDERATIONS • Closely monitor patient’s blood pressure , especially when therapy starts and dosage increases. • Monitor renal function tests for sign of nephrotic syndrome, such as proteinuria and increased BUN. • Monitor WBC, regularly.
- 9. REMIPRIL • Brand name: Altace. • Dosage: Oral capsule: 1.25 mg, 2.5 mg, 5 mg, 10 mg • Action: It blocks conversion of angiotensin I to angiotensin II , causing vasodilation, and reduces aldosterone secretion. It prevents water retention. • Indications: Hypertension, congestive heart failure.
- 10. CONTRAINDICATIONS • Contraindications to its use include renovascular disease (impaired blood flow in the kidneys) • severe renal impairment (especially in patients with one kidney or with bilateral renal artery stenosis) • volume-depleted patients • Pregnancy • Hypotension
- 11. SIDE EFFECTS Feeling like pass out. high potassium level dry mouth thirst confusion swelling pale skin Easy bruising’ Jaundice Fever, chills.
- 12. NURSING CONSIDERARTIONS • Monitor BP . • Report diminished antihypertensive effect. • Monitor for first-dose hypotension, especially in salt- or volume-depleted persons. • Lab tests: Monitor BUN and serum Creatinine periodically. • Observe for S&S of hyperkalaemia
- 13. ENALAPRIN Generic name: Enalapril maleate Brand name: Vasotec Availability: 2.5 mg, 5 mg, 10 mg, 20 mg tablets; 1.25 mg/mL injection; 1 mg/mL suspension Action: ACE catalyses the conversion of angiotensin I to angiotensin II, a vasoconstrictor substance.
- 14. DOSES & INDICATION • Intravenous: Hypertension: Adult: 1.25 mg daily. • Maintence: 20 mg once daily as a single or in 2 divided doses up to 40 mg daily in 2 divided doses.
- 15. Contraindications: Hypersensitivity. History of angioedema , bilateral renal artery stenosis. Pregnancy. Side effects: Initial hypotension, Dizziness, headache, fatigue, persistent dry cough, abnormal taste, rash, neutropenia, renal impairment or failure.
- 16. NURSING CONSIDERATIONS • Allergy to enalapril, impaired renal function, salt or volume depletion, lactation, pregnancy • Be aware that use of this drug in second and third trimesters can cause serious injury or death to the foetus; advise contraceptive use. • Monitor patients on diuretic therapy for excessive hypotension after the first few doses of enalapril.
- 17. BENAZEPRIL • Generic name: Benazepril hydrochloride. • Trade name: Lotensin • Action of mechanism: Lowers blood pressure by specific inhibition of the angiotensin- converting enzyme (ACE) and thus by decreasing angiotensin II (a potent vasoconstrictor) and aldosterone secretion.
- 18. • Indications Mild to moderate hypertension ,CHF. • Contraindications: Hypersensitivity to benazepril or another ACE inhibitor. Safety during pregnancy (category D), lactation, or in children is not established. • Dosage: Adult: PO 10–40 mg/d in 1–2 divided doses
- 19. • Side effects: Hypotension, dizziness, fatigue, weakness, Azotaemia, oliguria, cough, rhinitis, bronchitis. • Nursing care: • Assess for hypotension, especially in patients who may be volume depleted. • Lab tests: Monitor serum potassium levels for hyperkalaemia.