Pharmacology of ACE Inhibitors, Slides of Pharmacology

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ACE

INHIBITORS

PHARMACOLOGICAL

ACTIONS OF ANGIOTENSIN

II

1.Blood vessel : Vasoconstriction by smooth muscle contraction thus results in increase in Bp

2.Kidney : ↑ Na/H₂O reabsorption results in increase in blood volume thus increase in Bp Angiotensin II stimulates the release of Aldosterone from adrenal cortex Aldosterone acts on distal tubule of nephron to reabsorb Na/H₂O and also Increase in K+ excretion

ACE INHIBITORS

They are the first choice of drugs in all grades of essential as well as renovascular hypertension It inhibits Angiotensin converting enzyme which inhibits the Angiotensin II formation Lower doses (enalapril 2.5-10 mg/day or equivalent) which are well tolerated

Used alone they can control hypertension in 50-60% patients, and addition of b blocker/ diuretics it can extend efficacy to ~90%

Pneumonic to remember the

action of ACE inhibitor

ACE

A- Angiotensin II Aldosterone ADH C- ↓ Constriction

USES:

Hypertension Heart failure Coronary artery disease/ MI Cardiac remodeling Renal disease

Side effects

Cough Angioedema Pregnancy problem Taste changes Other (rashes, fatigue) Proteinuria Renal insufficiency Increased potassium – hyperkalemia Low Bp