Angiotensin-Converting Enzymes

| 1. corticosteroid 2. bronchodilator 3. ACE inhibitor4. cholesterol 5. benzodiazepine 6. potassium sparing diuretic

The role of diuretics in heart failure is to reduce the fluid retention by diuresis (1). Patient should be monitored closely to prevent over diuresis that will subsequently lead to hypotension and renal impairment. Diuretic used is commonly associated with hypokalemia (1). Thus, additional potassium needs to be given concurrent to diuretic treatment (1). Patient’s daily weight must be recorded and aimed for reduction of body weight >4.5 kg in 5 days after treatment (7). Angiotensin converting enzyme inhibitor (ACE-I) is a first line agent in treating heart failure, especially when there is evidence of reduced in ejection fraction <40% as it improve survival rate of patient (1). Patient needs to be advised regarding side effects of the drug which are, dry cough, hypotension, renal insufficiency, hyperkalemia and angioedema. Antihypertensive agents that can be given in patient with heart failure are beta blocker, ACE-I and aldosterone antagonist. If the blood pressure is persistently high despite treatment with beta blocker, ACE-I and ARB, calcium channel blocker such as amlodipine can be added as this drugs has negative inotropic effect

Hypertension is the leading cause of cardiovascular diseases, and its prevalence rate is approximately 1 billion in 2000 people around the world (Hanus, Simões, Amboni, Ceretta, & Tuon, 2015). Additionally, HTN is a major risk factor for kidney, brain, and eye complications. Complications from HTN cause an estimated 9.4 million deaths per year (Kjeldsen et al., 2014). To reduce high morbidity rates and complications related to uncontrolled high blood pressure, pharmacological therapy is warranted. Despite available medications, the compliance with HTN medications remains subpar (Polinski, Kesselheim, Frolkis, Wescott, Allen-Coleman, & Fischer, 2014).

ACE inhibitors are important and useful in the medication and treatment for KH due to their effectiveness in treating hypertension. ACE inhibitors will help treat KH by slowing the angiotensin converting enzyme (ACE). Angiotensin II is produced by the body that can cause vasoconstriction of the blood vessels. Angiotensin II is made from Angiotensin I by the ACE. If the production of Angiotensin II is slowed by the ACE inhibitor, the blood vessels will be able to dilate, and blood pressure is able to be lowered (Copstead and Banasik). Thus, it is important for KH to stay on the ACE inhibitors due to his blood pressure readings. KH’s blood pressure is 135/96. His systolic blood pressure is in the pre-hypertensive range, however, his diastolic blood pressure is in the hypertensive range and therefore, his blood pressure is hypertensive. Since his blood pressure is high, it is important for KH to remain taking the

This particular research was driven by the demand of the regulatory guidelines that deals with reduction of risks. The cases of cardiovascular risks among patients are have been reported to increase in the recent days. The regulatory guidance require being presented for the cardiovascular outcomes that can be used in the therapies of type 2 diabetes treatment. However, the

Patients who have congestive heart failure and do not respond to diuretics may benefit from a combination of several types of diuretic medication, each with a different system of action. Another medication for someone that has congestive heart failure can take Beta-blockers. Side effects include fatigue, cold hands, headache, upset stomach, constipation, diarrhea, dizziness, and shortness of breath. Data reported from 17 studies, researchers came to the conclusion that the risk of death from all causes was 31 percent lower in patients with heart failure who were treated with beta-blockers than in those not receiving such medications. Aldosterone blockers is a form of medication one may take to help slow down the rate of congestive heart failure.This medication can sometimes affect kidney function and can also increase potassium levels. Aldosterone blockers are prescribed to individuals who develop heart failure after a heart attack. Studies show that these medications can reduce the risk of hospitalization and death from cardiovascular disease. The last form of medication is BiDil (isosorbide

While at the hospital, the patient, was having excessively slow AV nodal conduction rates that unfortunately haven’t been recognized. He started on the prescribed antihypertensive drug (s). As soon as blood levels climb towards the usual therapeutic range the patient goes into complete heart block. Which of the following drugs most likely provoked this further prolongation of the P-R interval, ultimately leading to the complete heart

drugs prevent the synthesis of prostaglandins, an enzyme, which are the body’s defence to injury.

Pharmacological treatments with diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers or aldosterone antagonist, and beta-blockers are essential for the treatment of heart failure and are effective in improving symptoms of heart failure and patient well-being. Diuretics are administered to help get rid of the excess fluid that helps improve breathing associated with shortness of breath, at rest or on exertion. Diuretics provide relief from symptoms and signs of pulmonary and venous congestion by promotion of fluid loss through the kidneys. Diuretics, for example, Furosemide helps improve breathing status, but monitoring patients for dehydration and kidney problems is crucial. Patient education is essential to ensuring medication adherence and early identification of adverse effects and potential for drug interactions.

The author also uses images to help understand the topic how CHF happens more efficiently. Further more in the article the author discusses how the nurses should manage CHF representing what medications are important elements of CHF treatment, such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptors blockers (ARBs), which the are key medication in managing CHF. Further more William & Wilkins (2012) indicate that diuretics are another class of medication that plays a major role in the treatment of CHF. The article also discusses other options that are available for patient whose condition is not under control, such as medical devices: pacemakers and other devices that can be implanted. For patient that in there last stage of CHF, the author suggested that palliative care and or hospice

Together ACE inhibitors and ARB’s work to lower heart rate and blood pressure by inhibiting the RAS (renin-angiotensin system) in the sympathetic nervous system. This “fight or flight” system is activated by the heart when it senses the inability of the ventricles to pump blood, in which cardiac output and blood pressure are decreased. These medications act by blocking this system and therefore decreasing blood pressure and heart rate (Markaity, 2012). Commonly used ACE inhibitors include: enalapril (Vasotec), benazepril (Lotensin), lisinopril (Prinivil, Zestril) and captopril (Capoten). Commonly used ARBs include: losartan (Cozaar), Candesartan (Atacand), Valsartan (Diovan) (heart.org).Common side effects of ACE inhibitors and ARBs are: dry cough, dizziness, hypotension and hyperkalemia. Renal function tests and serum potassium levels should be monitored periodically. ACE inhibitors and ARBs have a label of pregnancy category D while in the second and third trimesters

Usually angiotensin has an effect on the body to increase blood pressure, increase blood volume and increase pressure in the kidney. As the ACE inhibitor lowers the amount of angiotensin, this causes the blood vessels to become wider and there is an increase in the amount of urine produced by the kidneys. The result of this is the blood pressure goes down, blood volume decreases and decreases pressure in the kidneys. The decrease of angiotensin levels by ACE inhibitors also causes a drop in noradrenalin and aldosterone levels, which helps to reduce blood pressure. Another effect ACE inhibitors have is to increase bradykinin which also causes the blood vessels to widen with a further decrease in blood pressure. Examples of ACE inhibitors include; Lisinopril (Prinivil), Captopril (Capoten) and Enalapril

For years health care providers have been using drugs like beta blockers or ACE inhibitors to treat patients with heart failure, but with cardiovascular disease still being a leading cause of death, it is evident that current treatments have been lacking the ability to produce adequate results. However, with the newest heart failure drug on the market a positive change has finally come for heart failure patients. The new heart failure drug reigns far more superior when compared to the treatments healthcare professionals already use and can potentially alter the foundation of heart failure treatments altogether.

Medications that can cause interactions include anticoagulants, probenecid, bisphosphonates, angiotensin-converting enzyme (ACE) inhibitors, anticoagulants (Warfarin), antiplatelet medicines (Clopidogrel), aspirin, corticosteroids (Prednisone), heparin, other NSAIDs (Ibuprofen), Rivaroxaban, or Selective Serotonin Reuptake Inhibitors (SSRIs) (Fluoxetine) due to the risk of stomach bleeding may be increased. Bisphosphonates (Alendronate), Cyclosporine, Hydantoins (Phenytoin), Lithium, Methotrexate, Quinolones (Ciprofloxacin), Sulfonamides (Sulfamethoxazole), and Sulfonylureas (Glipizide) side effects may be increased by Naproxen. The effectiveness of Angiotensin-converting enzyme (ACE) inhibitors (Enalapril), Beta-blockers (Propranolol), or diuretics (Furosemide, Hydrochlorothiazide) may be decreased by Naproxen (Lexi-Comp,

Atacand HCT (Candesartan celexetil-hydrochlorothiazide) was developed for patients who were unsuccessfully treated with single antihypertensive agents. The proposed benefit is elicited by the drugs action on angiotensin II receptor antagonists, the agent that causes vasoconstriction. Additionally the second ingredient hydrochlorothiazide a diuretic reduces blood pressure by improving the kidneys ability to eliminate salt and fluid from the body (www.centerwatch.com).