ACE Inhibitors and ARBs

Overview

• Function: Lower blood pressure only (not heart rate)
• Important for NCLEX exam

ACE Inhibitors

• Suffix: End in "pril" (e.g., lisinopril)
• Mnemonic: "Chill pril" for the heart, indicating lower blood pressure
• Mechanism: Inhibit RAS (renin-angiotensin-aldosterone system) to prevent fluid retention
• Side Effects:
  • A (Avoid pregnant patients): Toxic to fetuses
  • A (Angioedema): Swelling of the face and tongue, airway risk, specific to ACE inhibitors
  • C (Cough): Common side effect
  • E (Elevated Potassium): Risk of potassium levels over 5.0

ARBs (Angiotensin Receptor Blockers)

• Suffix: End in "sartan" (e.g., losartan)
• Mnemonic: "Sartan" sounds like "relaxed man" or "retirement plan"
• Mechanism: Block RAS, similar to ACE inhibitors
• Side Effects: Do not cause cough or angioedema

Clinical Considerations

• Bradycardia: Do not hold if the heart rate is below 60 as they do not affect heart rate
• Contraindications: Only hold for low blood pressure, not low heart rate

Mechanism of Action

• Both ACE inhibitors and ARBs inhibit/block the RAS system
• Prevent aldosterone from increasing sodium and water retention
• Main issue: Risk of retaining too much potassium

Key Points

• ACE inhibitors and ARBs are crucial for managing blood pressure, not heart rate
• Be aware of side effects, especially elevated potassium levels and angioedema with ACE inhibitors
• Vital for NCLEX: Understanding when to hold or administer based on blood pressure, not heart rate