How ACE Inhibitors Work – A Key NCLEX Pharmacology Concept
ACE inhibitors (Angiotensin-Converting Enzyme inhibitors) are essential medications in the treatment of hypertension and heart failure. Understanding their pharmacodynamics is crucial for NCLEX preparation, as they frequently appear in medication-related questions.
Pharmacodynamics of ACE Inhibitors
Step 1: The Renin-Angiotensin-Aldosterone System (RAAS)
The RAAS system regulates blood pressure and fluid balance. It begins when the kidneys release renin, which converts angiotensinogen into angiotensin I.
Step 2: The Role of Angiotensin-Converting Enzyme (ACE)
ACE, an enzyme found in the lungs, converts angiotensin I into angiotensin II, a potent vasoconstrictor that increases blood pressure and stimulates aldosterone secretion, leading to sodium and water retention.
Step 3: How ACE Inhibitors Work
ACE inhibitors block the conversion of angiotensin I to angiotensin II, causing:
✅ Vasodilation – Lowering blood pressure
✅ Decreased aldosterone – Reduced sodium and water retention
✅ Increased bradykinin – May cause a dry cough, a common side effect
Clinical Applications
💊 Used for:
Hypertension (first-line therapy)
Heart failure
Post-myocardial infarction (to prevent remodeling)
Chronic kidney disease (CKD) – Slows nephropathy progression
🚨 NCLEX Tip: Monitor potassium levels! ACE inhibitors can cause hyperkalemia due to decreased aldosterone activity.
Common ACE Inhibitors for NCLEX
Here are some ACE inhibitors to remember for the NCLEX exam:
Lisinopril
Enalapril
Ramipril
Captopril
Side Effects to Watch For:
⚠️ Dry cough (due to increased bradykinin)
⚠️ Hyperkalemia
⚠️ Angioedema (rare but life-threatening)
NCLEX Practice Question
A patient prescribed lisinopril reports a persistent dry cough. What is the likely cause?
A) Increased aldosterone
B) Increased bradykinin
C) Decreased renin
D) Decreased potassium
💡 Answer: B) Increased bradykinin – ACE inhibitors prevent bradykinin breakdown, leading to a dry cough.
Conclusion
ACE inhibitors are NCLEX high-yield drugs, frequently tested in pharmacology and cardiovascular system questions. Understanding their pharmacodynamics, effects, and side effects is crucial for exam success.
Frequently Asked Questions (FAQs)
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