ACE Inhibitors and ARBs Overview
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Questions and Answers

Which ACE inhibitor can be administered parenterally?

  • Lisinopril
  • Captopril
  • Enalapril (correct)
  • Ramipril

What is a common adverse effect of ACE inhibitors related to blood pressure?

  • Unrelenting non-productive cough (correct)
  • Visual disturbances
  • Reflex bradycardia
  • Headache

Which of the following is NOT an indication for ARBs?

  • Chronic obstructive pulmonary disease (correct)
  • Heart failure in patients who cannot tolerate ACE inhibitors
  • Slowing progression of renal disease in type 2 diabetes
  • Hypertension

What effect do ARBs have on angiotensin II?

<p>Block vasoconstriction (D)</p> Signup and view all the answers

Which of the following is a key contraindication for calcium channel blockers?

<p>Renal dysfunction (D)</p> Signup and view all the answers

Which adverse effect is commonly associated with all classes of antihypertensive medications discussed?

<p>Hyperkalemia (B)</p> Signup and view all the answers

What is an important nursing implication when administering ACE inhibitors?

<p>Administer on an empty stomach (D)</p> Signup and view all the answers

Which of the following should be monitored due to the risk associated with hypotension when using ACE inhibitors?

<p>BUN and creatinine levels (B)</p> Signup and view all the answers

Which of the following medications is NOT a calcium channel blocker?

<p>Valsartan (D)</p> Signup and view all the answers

What should patients be warned about when taking ACE inhibitors regarding postural changes?

<p>They should move slowly to avoid orthostatic hypotension (D)</p> Signup and view all the answers

What is a potential life-threatening condition associated with ACE inhibitors?

<p>Angioedema (C)</p> Signup and view all the answers

Which of the following is a contraindication for ARBs?

<p>History of angioedema (C)</p> Signup and view all the answers

What effect do ARBs have on blood pressure?

<p>Block vasoconstriction (B)</p> Signup and view all the answers

Which adverse effect is associated with calcium channel blockers?

<p>Peripheral edema (B)</p> Signup and view all the answers

What should be monitored during the use of calcium channel blockers due to potential adverse effects?

<p>Blood pressure and cardiac status (A)</p> Signup and view all the answers

What is the main purpose of administering ACE inhibitors on an empty stomach?

<p>To improve absorption (A)</p> Signup and view all the answers

Which of the following is NOT a common indication for ACE inhibitors?

<p>Pulmonary hypertension (C)</p> Signup and view all the answers

What can be a consequence of administering ACE inhibitors during surgery without precautions?

<p>Postoperative hypotension (A)</p> Signup and view all the answers

What defines a primary adverse effect of ARBs?

<p>Angioedema (D)</p> Signup and view all the answers

Why should patients using calcium channel blockers avoid grapefruit juice?

<p>It can increase medication absorption to toxic levels (D)</p> Signup and view all the answers

Flashcards

ACE Inhibitors

Drugs that block the production of angiotensin II, a hormone that narrows blood vessels, used to treat hypertension and heart failure.

Angiotensin II Receptor Blockers (ARBs)

Drugs that block the angiotensin II from binding to its receptors, reducing blood vessel constriction, primarily used for hypertension.

Calcium Channel Blockers (CCBs)

Medication that relaxes blood vessels by blocking calcium channels, used for hypertension and angina.

ACE inhibitor Contraindications

Conditions that prevent ACE inhibitor use. Impaired kidney function, pregnancy, and allergies.

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ARB Contraindications

Conditions that prevent ARB use: Allergy, severe liver or kidney problems, avoid during pregnancy, and with concomitant use of ACEIs.

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ACEI Adverse Effects

Unwanted side effects of ACE inhibitors such as hypotension, cough, and angioedema.

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ARB Adverse Effects

Unwanted side effects of ARBs may include dizziness, headaches, and gastrointestinal issues.

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CCB Adverse Effects

Unwanted effects of CCBs include dizziness, headaches, and potential gastrointestinal complications affecting your stomach.

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ACEI and ARB Nursing Implications

Important elements to consider when administering ACE inhibitors or ARBs. Monitoring blood pressure, kidney function, and potential adverse effects as well as fluid intake.

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CCB Nursing Implications

Important factors to consider concerning CCB administration. Monitor BP and cardiac status, be aware of grapefruit juice interactions.

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What do ACE inhibitors target?

ACE inhibitors primarily target the renin-angiotensin-aldosterone system (RAAS) by blocking the conversion of angiotensin I to angiotensin II, which is a potent vasoconstrictor.

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What is the main action of ACE inhibitors?

ACE inhibitors lower blood pressure by preventing the production of angiotensin II, which causes blood vessels to narrow.

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What is the most common side effect of ACE inhibitors?

The most common side effect of ACE inhibitors is a persistent, dry cough that is not related to any underlying respiratory condition.

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What is the most dangerous side effect of ACE inhibitors?

The most dangerous side effect of ACE inhibitors is angioedema, a potentially life-threatening swelling of the face, lips, tongue, and throat.

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What are the main uses of ACE inhibitors?

ACE inhibitors are primarily used to treat hypertension, heart failure, and sometimes diabetic neuropathy.

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What are ARBs?

ARBs, or angiotensin II receptor blockers, are a class of medications that directly block the effects of angiotensin II by preventing it from binding to its receptors on blood vessels and adrenal glands.

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How do ARBs affect blood pressure?

ARBs block the effects of angiotensin II, preventing vasoconstriction and aldosterone release, leading to overall blood pressure reduction.

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What is the function of the cytochrome P450 system?

The cytochrome P450 system is a group of enzymes primarily involved in the metabolism of drugs, playing a significant role in breaking down medications and detoxifying the body.

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How do calcium channel blockers lower blood pressure?

Calcium channel blockers work by relaxing blood vessels and reducing the force of the heart’s contractions, both of which lead to lower blood pressure.

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What is the most important nursing implication for patients on calcium channel blockers?

Patients on calcium channel blockers should be advised to avoid grapefruit juice as it can significantly increase the concentration of the medication, potentially leading to adverse effects.

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Study Notes

ACE Inhibitors (PRILS)

  • Mechanism of Action: Inhibit Angiotensin-Converting Enzyme (ACE), reducing RAAS activity.
  • Administration: Oral (PO) except enalapril, which can be parenteral.
  • Metabolism/Excretion: Metabolized in the liver, excreted in urine and feces.
  • Examples: Lisinopril, enalapril (Vasotec), captopril (Capoten).
  • Indications: Hypertension, heart failure, diabetic neuropathy, left ventricular dysfunction post-MI.
  • Contraindications/Precautions: Allergy, impaired renal function, pregnancy, surgery (monitor for hypotension, may need volume expanders).
  • Adverse Effects: Reflex tachycardia, angioedema, GI irritation, renal insufficiency/failure (proteinuria), cough, hypotension, hyperkalemia.
  • Nursing Implications: Administer on an empty stomach, monitor BUN/creatinine, I&O, hypotension (especially with fluid loss), orthostatic hypotension precautions.

ARBs (TANS)

  • Mechanism of Action: Block angiotensin II receptors in smooth muscle and adrenal glands, preventing vasoconstriction and aldosterone release.
  • Administration: Oral (PO) only.
  • Metabolism/Excretion: Metabolized by the liver (CYP450), excreted in urine and feces.
  • Examples: Losartan, valsartan, irbesartan.
  • Indications: Hypertension, heart failure (in ACE inhibitor intolerant patients), slows progression of renal disease (type 2 diabetes and hypertension).
  • Contraindications/Precautions: Allergy (angioedema), hepatic/renal dysfunction, hypovolemia, pregnancy (teratogenic), do not use with ACEIs.
  • Adverse Effects: Headache, dizziness, syncope, weakness, hypotension, GI complaints (diarrhea, abdominal pain, nausea), dry mouth/tooth pain, respiratory issues (cough), renal damage, hyperkalemia.

Calcium Channel Blockers (Pines)

  • Mechanism of Action: Vasodilate arteries, decreasing blood pressure, cardiac workload, oxygen consumption, and contractility.
  • Administration: Primarily oral (PO), but some IV forms available.
  • Examples: Amlodipine, nicardipine, diltiazem, nifedipine.
  • Indications: Reduce blood pressure, decrease cardiac workload, decrease myocardial oxygen consumption.
  • Contraindications/Precautions: Allergy, heart block, sick sinus syndrome, renal/hepatic dysfunction, pregnancy (no well-defined studies, nifedipine sometimes used to treat BP).
  • Adverse Effects: Dizziness, lightheadedness, headache, fatigue, GI issues (nausea, constipation), hepatic injury, hypotension, bradycardia, peripheral edema, heart block, skin flushing, rash.
  • Nursing Implications: Caution with grapefruit juice (increases drug levels), monitor blood pressure and cardiac status, administer on an empty stomach.

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Description

This quiz covers the mechanisms, administration, indications, and adverse effects of ACE inhibitors and ARBs. It is essential for understanding the pharmacological management of hypertension and heart failure. Prepare to test your knowledge on these critical medications and their nursing implications.

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