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?

Block vasoconstriction Signup and view all the answers

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

Renal dysfunction Signup and view all the answers

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

Hyperkalemia Signup and view all the answers

What is an important nursing implication when administering ACE inhibitors?

Administer on an empty stomach Signup and view all the answers

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

BUN and creatinine levels Signup and view all the answers

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

Valsartan Signup and view all the answers

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

They should move slowly to avoid orthostatic hypotension Signup and view all the answers

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

Angioedema Signup and view all the answers

Which of the following is a contraindication for ARBs?

History of angioedema Signup and view all the answers

What effect do ARBs have on blood pressure?

Block vasoconstriction Signup and view all the answers

Which adverse effect is associated with calcium channel blockers?

Peripheral edema Signup and view all the answers

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

Blood pressure and cardiac status Signup and view all the answers

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

To improve absorption Signup and view all the answers

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

Pulmonary hypertension Signup and view all the answers

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

Postoperative hypotension Signup and view all the answers

What defines a primary adverse effect of ARBs?

Angioedema Signup and view all the answers

Why should patients using calcium channel blockers avoid grapefruit juice?

It can increase medication absorption to toxic levels Signup and view all the answers

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.