Angiotensin-Converting Enzyme (ACE) Inhibitors (enalapril)

Which statement by an individual taking prescribed captopril indicates further teaching is required?

"I take the first dose each day with breakfast, then space them out evenly until bedtime."

How does captopril impact the vasoconstriction, aldosterone secretion, and renin release that occur as a result of the renin-angiotensin-aldosterone system? Select all that apply.

*Blocks aldosterone secretion *Inhibits vasoconstriction

A person is prescribed an Angiotensin Converting Enzyme (ACE) Inhibitors after experiencing a myocardial infarction. What effects on the body will this medication achieve? Select all that apply.

*Kidneys will retain potassium *Kidneys will excrete water and sodium *Decreases SVR (systemic vascular resistance) and blood pressure

Click on the cells that contain the therapeutic effects of ACE inhibiting medications. Select all that apply.

*Lower blood pressure *Slow development of HF *Improve survival after heart attack *Lessen HF symptoms

By which mechanisms do ACE inhibitors cause systemic vasodilation and lower blood pressure? Select all that apply.

*Stop the conversion of angiotensin I to angiotensin II *Prevent the breakdown of bradykinin

Which of the oral ACE inhibitor medications are ready to be used by the body as soon as they are absorbed? Select all that apply.

*captopril *lisinopril

Which of the angiotensin converting enzyme (ACE) inhibitors have been shown to reduce the risk of death or development of heart failure (HF) following a myocardial infarction (MI)? Select all that apply.

*trandolapril *captopril *lisinopril

In addition to hypertension, ACE Inhibitors are also prescribed to prevent 1.___________________ after a myocardial infarction and decrease the morbidity and mortality associated with 2.______________.

1. Left ventricular hypertrophy 2. Heart failure

ACE inhibitors should be used cautiously in individuals with 1.________________ and those with a family history of 2._____________________.

1. Liver disease 2. Angioedema

The health care provider suspects these symptoms are related to 1.__________________ and recommends the individual 2.____________________.

1. the onset of angioedema 2. call 911 immediately

Which individual would benefit most from an ACE inhibitor?

50-year-old female with systolic dysfunction heart failure

Use the drop down menus to fill in the missing information related to dosing of captopril.

Dose: 12.5-20 Frequency: 2-3 times Considerations: 150

A patient states they are experiencing an annoying, persistent dry cough that started once they begin taking an ACE inhibitor. The patient is not experiencing any other signs and symptoms. What is the best response by the health care provider?

Explain that this is a known, harmless side effect of the medication

Indicate which medications will increase or decrease the effectiveness of ACE inhibitors by clicking the radio button in the correct column.

Increase ACE Inhibitor Effectiveness -Diuretics -Nitrates Decrease ACE Inhibitor Effectiveness -Tricyclic antidepressant -Monoamine oxidase inhibitors (MAOIs) -Appetite suppressants

Which ACE inhibitor is not metabolized by the liver and is eliminated unchanged in urine?

Lisinopril

Use the drop down menus to fill in the missing pharmacokinetic information of enalapril.

Onset: 1 Peak: 4-8 Half-Life: 2 Duration: 12-24