ACE Inhibitors • Beta Blockers • Diuretics
Course: Pharmacology (Cardiovascular System)
Primary Reference: Katzung – Basic & Clinical Pharmacology, 16th Edition
Study Program: Nursing / Medicine / Clinical Health Sciences
Document Type: Course Summary & Exam Revision Notes
Level: Undergraduate (Year 2–3)
What This Summary Includes :
Katzung-aligned mechanisms
Clinical uses & pharmacodynamics
Adverse effects & contraindications
Nursing & exam-focused points
High-yield memory tips
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, 1. ANGIOTENSIN CONVERTING ENZYME (ACE )
INHIBITORS
(Katzung BCP 16e – Renin–Angiotensin–Aldosterone System)
Common Drugs (-pril)
Captopril
Enalapril
Lisinopril
Ramipril
Mechanism of Action
Inhibit angiotensin-converting enzyme (ACE)
↓ Conversion of Angiotensin I → Angiotensin II
↓ Vasoconstriction
↓ Aldosterone secretion
↓ Sodium and water retention
↑ Bradykinin levels → vasodilation
Pharmacologic Effects
↓ Peripheral vascular resistance (afterload)
↓ Blood pressure
↓ Cardiac remodeling in heart failure
Reno protective effects in diabetes
Therapeutic Uses
Hypertension
Chronic heart failure
Post–myocardial infarction
Diabetic nephropathy
Adverse Effects
Dry cough (Bradykinin-mediated)
Hypotension (first-dose effect)
Hyperkalemia
Acute renal failure (renal artery stenosis)
Angioedema (rare but fatal)
Contraindications
Pregnancy (teratogenic)
Bilateral renal artery stenosis
History of angioedema
Nursing & Exam Notes
Monitor blood pressure, renal function, and serum potassium
Warn patient about cough
Stop drug immediately if angioedema occurs
Memory Tip:
“ACE → Cough, K⁺ ↑, BP ↓”
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