A.C.E Inhibitors Flashcards

Study Notes

A.C.E Inhibitors Overview

A.C.E inhibitors include medications such as captopril, benazepril, enalapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, and trandolapril.
These medications inhibit the angiotensin-converting enzyme, which converts angiotensin I to angiotensin II.

Physiological Effects

Angiotensin II is a potent vasoconstrictor that raises blood pressure by inducing aldosterone secretion, which stimulates sodium and water resorption.
Aldosterone's actions increase blood volume, contributing to elevated blood pressure.

Uses and Indications

A.C.E inhibitors are the first line of treatment for heart failure and hypertension.
They are beneficial in treating heart failure by preventing sodium and water resorption through inhibition of aldosterone secretion.
A.C.E inhibitors help decrease preload by reducing left ventricular end-diastolic volume, which lowers the heart's workload.

Pharmacokinetics

Captopril and lisinopril are advantageous in patients with liver dysfunction as they are not prodrugs and do not require liver metabolism.
Captopril is a prodrug with a short half-life, causing potential side effects such as excessive blood pressure decrease, increased potassium levels, and first-dose hypotension.
Enalapril is unique among A.C.E inhibitors for being available in a parenteral preparation.
Other A.C.E inhibitors like benazepril, fosinopril, lisinopril, quinapril, and ramipril have long half-lives, allowing for once-daily oral dosing.

Safety in Pregnancy

A.C.E inhibitors are classified as pregnancy category C in the first trimester and D in the second and third trimesters, indicating potential risks to the fetus.

Mechanism of Action

A.C.E inhibitors lower blood pressure by preventing the breakdown of bradykinin and substance P, both of which are vasodilators.
This mechanism decreases systemic vascular resistance, thereby lowering afterload on the heart.

Cardiac Protection

A.C.E inhibitors can stop the progression of left ventricular hypertrophy post-myocardial infarction (MI) and prevent pathological ventricular remodeling, referred to as a cardioprotective effect.
They exhibit significant cardiovascular effects that improve overall heart function.

Renal Benefits

These medications provide a protective effect on the kidneys by reducing glomerular filtration pressure, making them a preferred choice for diabetic patients.
A.C.E inhibitors have been shown to reduce proteinuria and help prevent the progression of diabetic nephropathy.

Description

Test your knowledge of A.C.E inhibitors with these flashcards. Each card highlights different aspects of A.C.E inhibitors, including definitions and various types. Perfect for anyone studying pharmacology or medicine.