ACE Inhibitors ( Angiotensin Converting Enzyme Inhibitors) . A class of anti-hypertensive medications used to treat Hypertension.

1. ACE
Inhibitors
Anti-Hypertensive
Muhammad Yasir
Northwest School Of Medicine,peshawar

2. ACE Inhibitors
It blocks Angiotensin converting enzyme also called
kininase II.
1. ACE Inhibitors are medications that belong to the class of
medications known as antihypertensive medications.
1. ACE Inhibitors work on the Renin-Angiotensin Aldosterone
System.
1. ACE Inhibitors blocks formation of Angiotensin II.

4. Functions of Angiotensin II.
1. Can act directly on kidneys to cause salt and water retention.
2. Causes the adrenal gland to secrete aldosterone and aldosterone in turn
increases salt and water reabsorption by kidney tubules.
3. It causes vasoconstriction of renal arterioles.
4. It acts on the pituitary gland to secrete ADH and ADH leads to
reabsorption of water and blood vessels constrictions.
5. It also stimulate thirst to help replace volume losses.

5. Generic Name Trade Name
1. Captopril Capoten.
2. Enalapril Renitec.
3. Lisinopril Zestril.
4. Ramipril Ramipace/Cardace/Tritace.
5. Fosinopril,Moexipril,Perindopril,Quinapril,benazepril.
ACE Inhibitors include...

6. MOA of ACE Inhibitors Inhibits the generation of of angiotensin II resulting in…
1. Dilatation of arterioles Dec PVR Dec BP .
2. Decrease in aldosterone production Decrease Na and Water
retention Dec BP
3. Decrease in sympathetic nervous system activity.
4. inhibits degradation of bradykinin(potent vasodilator) by ACE.
5. Stimulate synthesis of vasodilating prostaglandins Via Bradykinin.
All these effects contribute to their Antihypertensive
effect

7. Uses for ACE inhibitors
Doctors prescribe ACE inhibitors to prevent, treat or improve symptoms in
conditions such as:
1. High blood pressure
2. Coronary artery disease
3. Heart failure
4. Diabetes
5. Certain chronic kidney diseases
6. Heart attacks

8. Pharmacokinetics
❖ Captopril Enalapril Ramipril
➢ Rapidly absorbed from GIT after oral administration.
➢ Food reduces their Bioavailability.
❖ Enalapril Ramipril
➢ Pro-drugs,converted to their active metabolites in the liver.
➢ Long half-life, given OD.
❖ Enalaprilat
➢ The active metabolite of Enalapril.
➢ Given I/V in Hypertensive Emergencies.

9. Adverse Reactions
1. Cough.
2. Acute renal failure.
3. Pregnancy.
4. Taste alteration.
5. Angioedema.
6. Proteinuria.
7. Urticaria.
8. Hyperkalemia.
9. First Dose Hypotension.

10. Drug Interactions
1. Antihypertensive agents Can cause an increased effect of
medications especially with diuretics.
2. Potassium increasing medications Can cause an increased risk
of hyperkalemia.
3. Lithium Increases the risk of lithium toxicity.
4. Allopurinol Increases hypersensitivity to medication.
5. NSAIDS Reduce antihypertensive effects of medication.