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ACE: Mechanism of Action
Inhibit ACE (responsible for converting angiotensin I to angiotensin II) blocking the potent vasoconstriction and aldosterone secretion effects of angiotensin II
ACE: Therapeutic Effects
Less aldosterone = less water and Na+ retention = decreased blood volume (the resulting diuresis decreases preload and workload of the heart)
Prevents breakdown of vasodilating substance Bradykinin
Results: decreased afterload (resistance) and vasodilation = decreased BP
ACE: DOC/First Line Drugs for...
Often used as first line drugs for HF and HTN
DOC in HTN w/ HF
DOC for diabetics
HF, HTN, renal protective effects in diabetic pts, slows progression of L ventricular hypertrophy after an MI
ACE: Adverse Effects
Dry, nonproductive cough (reverses if therapy stopped)
Angioedema, 1st dose hypotensive effect, mood changes, impaired taste, possible hyperkalemia, renal failure, sexual dysfunction
ACE: Drug Interactions
K+ sparing diuretics - additive K+ retention, risk of toxicity
ACE: Nursing Implications
Monitor renal FX and K+ levels, jaundice
Take before meals, no antacids, salt substitutes, no K+ supplements, notify MD of cough
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