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Angiotensin exists in two varieties in the human body: angiotensin I and II. Angiotensin I isn't much of a problem, but angiotensin II is responsible for constricting blood vessels, and angiotensin converting enzyme (ACE) is the substance that converts harmless angiotensin I into dangerous angiotensin II. A family of drugs called angiotensin converting enzyme inhibitors work to reduce the amount of ACE in the body, generally as a treatment for both hypertension and congestive heart failure. Reducing ACE not only reduces angiontensin II, but also increases potassium and decreases the amount of blood in the body.

ACE inhibitors

Brand/Generic Drug Names

Lotensin/ benazepril, Vasotec/enalapril, Monopril/fosinopril, Accupril/quinapril, Altace/ramipril, Capoten/captopril, Prinivil and Zestril/lisinopril, trandolapril
Common uses
hypertension, congestive heart failure, diabetic nephropathy, left ventricular dysfunction after myocardial infarction, pheochromocytoma
Pharmacology
competitively block the angiotensin I converting enzyme necessary for conversion to angiotensin II, decreasing vascular tone, lowering blood pressure, blocking release of aldosterone, increasing plasma renin activity
Class contraindications
pregnancy
Class precautions
history of angioedema, impaired renal function, hyperkalemia, hyponatremia, volume depletion, allergy, cerebrovascular and coronary insufficiency
Interactions
Severe hypotensive episode: alcohol, diuretics
Hyperkalemia: potassium-sparing diuretics, low-salt milk, potassium supplements, potassium-containing medications/salt substitutes
Adverse Reactions
dry cough, headache, nausea, diarrhea, loss of taste, weakness, dizziness, hypotension, rash, fever, joint pain, neutropenia, agranulocytosis, pancreatitis, nephritic syndrome
Additional Information
Assess vitals, blood and renal studies
Evaluate therapeutic response: decreased blood pressure
Date of most recent Update
August 06, 2002
Further information is available in the writeup for the specific name(s) of this medication class

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