Ace inhibitors pdf nikhil

power point drug presentation on ACE inhibitors

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.