A.C.E Inhibitors Flashcards
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A.C.E Inhibitors Flashcards

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Questions and Answers

Which of these are A.C.E inhibitors? (Select all that apply)

  • Metoprolol
  • Benazepril (correct)
  • Captopril (correct)
  • Lisinopril (correct)
  • What do A.C.E inhibitors inhibit?

    Angiotensin-converting enzyme

    What does aldosterone stimulate?

    Sodium and water resorption

    In which conditions are A.C.E inhibitors the first line of treatment?

    <p>Heart failure and hypertension</p> Signup and view all the answers

    What is the effect of angiotensin?

    <p>Potent vasoconstrictor</p> Signup and view all the answers

    What is a prodrug?

    <p>Inactive form of a drug</p> Signup and view all the answers

    Why do captopril and lisinopril have advantages in treating certain patients?

    <p>They are not prodrugs</p> Signup and view all the answers

    Captopril is a prodrug.

    <p>False</p> Signup and view all the answers

    What is Enalapril known for?

    <p>Only A.C.E inhibitor available in parenteral preparation</p> Signup and view all the answers

    A.C.E inhibitors are classified as pregnancy category D in the first trimester.

    <p>False</p> Signup and view all the answers

    What does kininase normally do?

    <p>Breaks down bradykinin</p> Signup and view all the answers

    What are the primary effects of A.C.E inhibitors?

    <p>On the cardiovascular and renal system</p> Signup and view all the answers

    How do A.C.E inhibitors decrease systemic vascular resistance?

    <p>By preventing breakdown of the vasodilating substance bradykinin</p> Signup and view all the answers

    What effect does decreasing preload have?

    <p>It reduces the work required of the heart</p> Signup and view all the answers

    What is the cardioprotective effect of A.C.E inhibitors?

    <p>Preventing pathological processes of ventricular remodeling</p> Signup and view all the answers

    How do A.C.E inhibitors affect the kidneys?

    <p>They have a protective effect</p> Signup and view all the answers

    What condition can A.C.E inhibitors help prevent in diabetic patients?

    <p>Progression of diabetic nephropathy</p> Signup and view all the answers

    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.

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