ACE Inhibitors ARBs

 Stops Angiotensin I from converting to Angiotensin II  Block the effects of Angiotensin II by preventing binding of
Angiotensin II to its receptor
USED FOR USED FOR
 HTN, Diabetic nephropathy, prevents remodeling after MI,  HTN
prevents progression of HF ( CHF ), Prevents stoke, MI  CHF
Drugs  Diabetic nephropathy
o Enalapril  MI
 Given only IV Drugs
o Lisinopril  Losartan
 Given PO as prodrugs  Valsartan
 Undergo conversion to active form in liver Side Effects
or small intestine  NO COUGH
Side Effects  Hypotension
o Dry, persistent cough due to build up of Bradykinin  Angioedema (rare)
o Hyperkalemia (affecting aldosterone)  Fetal Injury
o Hypotension (orthostasis) Nursing Implications
o Angioedema (swollen tongue, lips, cheeks; some people  Monitor
go to ER thinking it’s Anaphylaxis) o BP
Nursing Implications o SCr
o Monitor o K+
 BP
 An alternative to using ACE inhibitors for people who cannot
 SCr
handle cough
 K+
 ***second choice
 Less affective in African Americans
 *** first choice Drug if patient cannot take the cough no more
or for other reason, we will use ARBs