What Is Angiotensin-Converting Enzyme Inhibitors?

Lightheadedness and fainting may also be signs of toxicity (Medline Plus, 2015).While patients are taking Lisinopril their blood pressure should be monitor closely and they should have BUN/or ALT and AST did to check their liver function (Micromedex, 2017). Mrs. Cynthia is at risk of developing hyperkalemia because she is diabetic and taking this drugs (Toxnet, 2017). Other patients that are at risk are those with renal impairment, those taking drugs that can elevate their potassium level (Toxnet, 2017). A patient who is pregnant should not take Lisinopril and if they become pregnant they should stop the medication and inform their doctor. It can harm both mother and baby by causing low blood pressure, damage to the kidney and even cause the death of the newborn (American Heart Association, 2017).

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

Varying patients may present to their clinician or the emergency department for treatment with heart failure. It is important to understand that there is more than one type of heart failure; primarily the focus is placed on diastolic heart failure and systolic heart failure. Depending upon the cause of heart failure and what areas are affected dictates the treatment plan needed. While there are similarities with both kinds of heart failure, there are also differences that can help the clinician distinguish the diagnosis needed to fit the patient. Once a diagnosis is made the clinician can move forward in determining if the patient is at risk for use of diuretics and then look towards prescribing ACEIs, ARBs, and beta-blockers.

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 study shows that disease-modifying medications were prescribed significantly more often in 2000 than in 1995, particularly in patients younger than 65 and in those aged 75 to 84 (Saczynski et al., 2009, p. 3). The study indicates that Beta-blockers and ACE inhibitors have been shown to improve survival and reduce hospitalizations in patients with Heart Failure. The second article mentioned about the elderly patients who have CHF not on or under dosage of Angiotensin Converting Enzyme (ACE) inhibitors. According to this article ACE inhibitors should be given for patients diagnosed asymptomatic left ventricular systolic dysfunction (LVSD) (EF<40%) and symptomatic heart failure with systolic dysfunction associated with other heart problems such as myocardial infarction, pulmonary hypertension. The suggested dosage for the CHF patients mentioned in the article and due to age-related changes in pharmacokinetic drugs, it also recommended the initial dosage must be half the standard dose and gradual increase after assessing renal function. After studying a group of elderly CHF patients revealed that higher or standard dose of ACE inhibitors reduce the risks of major clinical events. Results from the research display a decrease of hospitalizations due to cardiovascular reason, heart failure, and ischemic events in the standard-dose group. The study also found out that the adverse effects of high doses can be managed by reducing the dosage or by changing

Enalapril, which is a part of the class of drugs called ACE inhibitors, is superior to the combination treatment mentioned above but is not an option for many patients. There is a subgroup in the general population that cannot tolerate ACE inhibitors or ARBs due to their side effects. In this case, the combination of isosorbide dinitrate and hydralazine is a superior treatment for these patients. (MGMT) Overall, the combination treatment is inferior to other heart failure treatments but it still has its own place in heart failure treatment guidelines.

There are different classes of medications used in the treatment of heart failure. While all these classes work differently, the main goal is to reduce the blood pressure of the patient as well as ease respiration that in most cases is compromised due to pulmonary congestion. Among these medications, beta adrenergic blockers, Angiotensin Converting Enzyme (ACE) inhibitors, and diuretics

Congestive Cardiac Failure bring an adverse impact on both people’s life and health care systems. Therefore, medication treatment might play an indispensable part in coping with congestive cardiac failure. There are different types of medication could be used to treat CHF, for example, angiotensin- converting enzyme(ACE) inhibitors, β-blockers and digoxin. What’s more, congestive cardiac failure are less likely to accept aspirin, heparin, oral beta-blockers, however, they are more likely to accept angiotensin-converting enzyme(ACE) inhibitors(Garry, Wilson, & Vlodaver, 2017).

Information to patient: Indicated for hypertension and angina. Reduce the blood pressure and risk of stroke and heart attack. They are calcium channel blockers which works by widening your blood vessels making it easier for your heart to pump blood around the body and help increase blood and oxygen supply to the heart. Taken once daily with or without food at the same time each day. Swallow the tablet whole with a full glass of water. Taking the tablet at the same time each day will have the best effect. It will also help you remember when to take it. You are currently on 5mg but your doctor might increase this depending on how you respond to the medication. Tell your doctor

They are considered a first line drug to treat hypertension and heart failure. Overall, diuretics will decrease blood volume, decrease venous and arterial pressure (preload and afterload), and decrease edema both peripheral and pulmonary (Burcham 519). Thiazide diuretics are mild and only work with relatively normal glomerular filtration rate; if the patient has low GFR a thiazide will not provide optimal benefits. When low GFR is indicated a loop diuretic may be the better choice. These diuretics produce an exceptional amount of fluid loss; therefore, these drugs should be reserved for patients with especially decreased cardiac output. When combined with an ACEI or and ARB, both the thiazide diuretic and the loop diuretic could substantially improve symptomatic complication in the patient; however, the patients can experience some adverse side effects. Both can cause hypokalemia due to the increased water elimination, this can be avoided by including a potassium supplement in the daily routine or conscientiously eating foods high in potassium. Potassium-sparing diuretics can cause hyperkalemia because of the potassium sparing effects, especially when paired with an ACEI or

The drug phosphodiesterase inhibitors are contraindicated in the presence of allergy to these drugs, to prevent hypersensitivity reactions. These drugs are also contraindicated in severe aortic or pulmonic valvular disease, acute MI, fluid volume deficit, and ventricular arrhythmias (Karch, 2013). This drug should be used with caution in elderly and during pregnancy and lactation. The adverse effects with phosphodiesterase inhibitors include ventricular arrhythmias, hypotension, and chest pain (Karch, 2013). GI effects include nausea, vomiting, anorexia, and abdominal pain. Thrombocytoenia is another adverse effect seen with milirone and inamrinone. The hypersensitivity reactions with these drug include vasculitis, pericarditis, pleuritis, and ascites (Karch, 2013). These drugs should not be combined as solutions with furosemide because this will form precipitates. Burning at the intravenous injection site is also a frequent side effect. ACE inhibitors are contraindicated in the presence of allergy to prevent hypersensitivity reactions and with impaired renal function (Karch,

Lisinopril and levofloxacin were prescribed for Mr. P. Lisinopril was prescribed to treat Mr. P’s new found hypertension. Lisinopril is considered an angiotensin converting enzyme inhibitor (ACE inhibitor). ACE inhibitors are designed to block the vasoconstrictive properties by angiotensin II (Gutierrez, 2008, p712). By blocking this action, and dilating the arteries, the increased workload of the heart is once again decreased, causing decreased blood pressures again (Gutierrez, 2008, p712). ACE inhibitors also help the kidneys excrete sodium and water, thus decreasing the blood volume and decreasing the workload of the heart (Gutierrez, 2008, p712). ACE inhibitors “are biotransformed in the liver” (Gutierrez, 2008, p713, para 5). Excretion occurs through the urine and stool (Gutierrez, 2008, p713).

In the modern medical society, scientists/doctors have adopted the use of medicines known as Angiotensin-converting enzymes or ACE inhibitors which are ideal for treating kidney, blood vessel and heart problems (Updated by: Michael A. Chen, 2015).This particular medicine works by lowering blood pressure and ultimately manages any disease to prevent it from getting any worse. Often patients with heart failures will be prescribed with this medicine. This essay will give a detailed explanation and description of the benefits, side effects as well as the physiological mechanism of ACE inhibitors.

Given the scenario where a 60 year old man comes into the emergency room complaining of shortness of breath and chest pain radiating to neck. He has a history of hypertension, and was on an angiotensin I converting enzyme (ACE) inhibitor, but discontinued use 2 weeks ago. There are a number of factors to consider when coming to a definite conclusion in this situation.

Other side effects include cloudy urine, proteinuria, irregular heartbeats, and chest pain. Angioedema involving the extremities, face, lips, mucous membranes, tongue, glottis or larynx has been seen in patients treated with ACE inhibitors, including captopril (Capoten, 2014). If these effects happen nurses should be ready to administer epinephrine to reduce swelling. Other adverse effect according to Karch (2014) include, “CV: Tachycardia, angina pectoris, heart failure, MI, Raynouds syndrome, hypotension in salt-or volume depleted patients.”