ACE Inhibitors

1. ACE Inhibitors By Jessica Davies

2. What are ACE Inhibitors? • Angiotensin Converting Enzyme Inhibitors • Used to help control Hypertension • Also they help with heart failure, preventing strokes, and preventing kidney damage in people with hypertension or diabetes. • They also improve survival after heart attacks. In studies, individuals with hypertension, heart failure, or prior heart attacks who were treated with an ACE inhibitor lived longer than patients who did not take an ACE inhibitor.

3. Examples

4. How do ACE Inhibitors work? • Angiotensin II is a very potent chemical that causes the muscles surrounding blood vessels to contract (narrowing the vessels). • Narrowing of the vessels increases the pressure within the vessels causing hypertension. • Angiotensin II is formed from angiotensin I in the blood by the enzyme angiotensin converting enzyme (ACE).

5. How do ACE Inhibitors work? • ACE inhibitors are medications that slow (inhibit) the activity of the enzyme ACE, which decreases the production of angiotensin II. • As a result, the blood vessels enlarge or dilate, and blood pressure is reduced. • This lower blood pressure makes it easier for the heart to pump blood and can improve the function of a failing heart. • In addition, the progression of kidney disease due to high blood pressure or diabetes is slowed.

6. Why are ACE Inhibitors used? • These medicines are used alone for high blood pressure or they are used with other medicines such as a diuretic. • ACE inhibitors are a good choice for people who have had a heart attack, because the medicine helps reduce the workload on the heart. • ACE inhibitors are a good choice for people who have diabetes, because this medicine does not affect blood sugar levels and may help protect the kidneys.

7. Why are ACE Inhibitors used? • If you have diabetes, you may take these medicines if you do not have high blood pressure but may have small amounts of protein in your urine (microalbuminuria), an early sign of kidney damage. • ACE inhibitors may be a good choice for people who have asthma or disorders of the electrical system of the heart that would be made worse by other blood pressure medicines such as beta-blockers. • ACE inhibitors may also help to prevent stroke.

8. Drug Interactions • ACE inhibitors may interact with other medicines such as nonsteroidal anti-inflammatory drugs (NSAIDs), antacids, potassium supplements, certain diuretics, and lithium. • Your doctor may check your potassium levels and how your kidneys are working to make sure this medicine is not causing problems.

9. Side Effects • ACE inhibitors are well-tolerated by most individuals. Nevertheless, they are not free of side effects, and some patients should not use ACE inhibitors. • ACE inhibitors usually are not prescribed for pregnant patients because they may cause birth defects. • Individuals with bilateral renal artery stenosis (narrowing) may experience worsening of kidney function, and people who have had a severe reaction to ACE inhibitors probably should avoid them.

10. Side Effects • The most common side effects are: cough,elevatedblood potassium levels, low blood pressure dizziness, headache, drowsiness,weakness, abnormal taste (metallic or salty taste), and rash. • It may take up to a month for coughing to subside, and if one ACE inhibitor causes cough it is likely that the others will too. The most serious, but rare, side effects of ACE inhibitors are kidney failure, allergic reactions, a decrease in white blood cells, and swelling of tissues (angioedema).

11. Video on Physiology • http://pharmacologycorner.com/mechanism-of-action-video-animation-ace-inhibitors-angiotensin-ii-receptor-blockers-arbs-and-the-renin-angiotensin-aldosterone-system/