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Monday, 15 August 2022

Angiotensin-Converting Enzyme (ACE) Inhibitors.

Angiotensin-Converting Enzyme (ACE) Inhibitors.


What are Angiotensin-Converting Enzyme (ACE) in a Inhibitors?

Angiotensin-Converting Enzyme in a  Inhibitors or  a ACE-I are drugs that are commonly prescribed for a treating hypertension (high blood pressure) and various heart in a conditions.


લંપી વાઇરસનો દેશી આયુર્વેદિક ઉપચાર જુઓ અહીંથી

How It is a Works

ACE is an a enzyme that helps to the form to a chemical known as a angiotensin II in the body. The function of the angiotensin II is to the constrict or a narrow in the blood vessels which in a turn increases blood pressure. Angiotensin II is also a responsible for a secreting certain hormones in the body that help regulate in the body’s water and sodium re-absorption through in the kidneys.

The retention of the water and the sodium by a kidneys raises in the blood pressure and the load of the blood volume reaching in the heart. The increase in a blood pressure and blood volume load boosts in the heart's workload.


ACE inhibitors prevent in the formation of the angiotensin II in the body, there by lowering blood pressure by a dilating or a expanding in the blood vessels. This way, in the medication helps to the lower blood pressure and reduce in the work load of the heart.

What Is It a Prescribed for?

Hypertension (high blood pressure)

Heart failure

Diabetic with a high blood pressure

Chronic kidney disease

Stroke

Heart and vascular disease in a diabetic and hypertensive patients

Kidney disease like a nephropathy or a treating nephropathy in a patients with a high blood pressure or a diabetes

After a heart attacks - Studies have shown in that people prescribed ACE-I after to a a heart attack have a lower chances of a repeat heart attack. Studies also a indicate that are prescribing ACE-I for a patients with a heart failure, lower left ventricular function live longer.

Examples of  the ACE-I include:

CaptoprilE

nalaprilLisi

noprilRami

prilBenaze

prilFosinop

rilMoexipri

lQuinaprilT

randolapril

What are the Side Effects of the Angiotensin-Converting Enzyme (ACE) in a Inhibitors?

Dry Cough- It is the most common side effect seen in a 5-20% of the patients treated with a  ACE-I. Normally ACE break downs a propagandist like a bradycardia in and substance pin tin he body. During a ACE-I administration there is an a accumulation of the propagandist which lead to the cough which is a usually resolved in a 1-4 days after a discontinuing in the drug.

Hyper kalemia- Increased a potassium levels in the blood.

Dizziness due to the low blood pressure

Angioedema- Rare adverse event. Seen in a 0.1-0.2% of the patients taking a ACE-I. It involves a swelling up of the tissues of the face, lips and throat. It can belief  threatening when tissues of the throat swell up, compromising in the airway. This is seen more commonly in a African Americans, smokers, women, people on a unimpressive medication, people with a history of the drug rash, seasonal allergies, and older people.

Fatigue, headache, altered sense of the smell, syncope (fainting) - Other rare side effects were are reported in a 1-10% of  the patients.

Drug Interaction

Non-Steroidal Anti-In a amatory Drugs (NSA-ID's) like a ibuprofen decrease in the effectiveness of the ACE-I. Occasional use of the NSA-IDs may not be cause a sign¬cant changes, long term users should consult with in their doctor.

ACE-I should not be a taken during a pregnancy as it is a harmful to the baby.

Cost

US - $10-30 for 30 tablets

India – Rs.480 to 1500 for  a 30 tablets

References

Patel S, Raul A, Khan H, Abu-Izneid T. Renin-angiotensin-aldosterone (R A A S): The ubiquitous system for a homeostasis and pathologist. Bio-med Pharmacotherapy. 2017 Oct;94:317-325. doi:10.1016/j.biopha.2017.07.091.Epub2017Jul31.PMID:28772209.

Hradec J. Pharmacological therapy for a chronic heart failure .Vnitr Lek. 2018 Fall;64(9):853-859. English. P M I D :30441998.

Heart Outcomes Prevention Evaluation Study Investigators, YusufS, SleightP, PogueJ, BoschJ, DaviesR, Dagenais G. Effects of anangiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Eng l J Med. 2000 Jan 20;342(3):145-53. doi:10.1056/NEJM200001203420301.Erratumin:2000May4;342(18):1376.Erratumin:NEnglJMed 2000Mar9;342(10):748.PMID:10639539.

IsrailiZH, HallWD. Cough and angioneurotic edema associated with angiotensin-converting enzyme inhibitor therapy. Are view of the literature and pathophysiology.AnnInternMed.1992Aug1;117(3):234-42.doi:10.7326/0003-4819-117-3-234.PMID:1616218.

GoyalA,CusickAS,ThielemierB. ACEInhibitors. [Updated2020Aug10]. In:StatPearls[Internet].TreasureIsland(FL):StatPearlsPublishing;2021Jan-.(https://ncbi.nlm.nih.gov/books/NBK430896/)

Polónia J. Interaction of antihypertensive drugs with anti-inflammatory drugs. Cardiology.1997;88Suppl3:47-51. doi:10.1159/000177507.PMID:9397294.


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