medical

1. ACE Inhibitor
By Abdullah Bin Mohd Subri

2. Mechanism of Action
• Inhibit generation of Ang II
-Vasodilation
-Decrease Na+ and H2O retention
-Decrease sympathetic nervous
system activity

3. Pharmacokinetics
- Orally
- HTN emergency: enalaprilat
(IV)
- Poorly cross BBB
- Metabolized in liver

4. Adverse effects contraindications
• Cough (dry cough) – intractable cough is an indication to stop
the drug
• Angioedema – nose, lip, mouth, throat, larynx, glottis
• Proteinuria
• Teratogenic – growth retardation, foetal hypotension, renal
failure, neonatal death (contraindicated in pregnancy)
• Hypotension – first dose (marked in CHF or volume depleted
patient)
• Neutropenia
• Rashes
• Itching
• Loss of taste sensation (dysgeusia)
• Hyperkalemia – due to renal insufficiency/ combined with
potassium-sparing diuretics
(CAPTOPRIL)
• Pregnancy
• Bilateral renal artery stenosis
• Single-kidney patient with bilateral
artery stenosis

5. • Hypertension – first line drugs in all grades of HTN
• Congestive Heart Failure (CHF) – cause arteriolar and venodilation
• Myocardial Infarction (MI)
• Prophylaxis in high cardiovascular risk subjects
• Diabetic nephropathy
• Scleroderma crisis – marked rise in BP, deterioration of renal function
mediated by Ang II
Uses of ACE Inhibitors

6. Role of ACE Inhibitor in Diabetic Nephropathy

7. References