Question

There are several drug classifications (e.g., benzodiazepines, ACE inhibitors). Choose a classification and one drug within that classification, and discuss the pharmacological aspects of this particular drug. Give examples of how and when this drug is used.

Answer 1

ACE inhibitors (Angiotensin Converting Enzyme inhibitors) area group of drugs used to treat hypertension or elevated blood pressure.These drugs simply dilate the blood vessels and increase the blood volume and the pumping capacity and hence decreasing the blood pressure. These drugs usually ends up with the "pril" eg., captopril,Benzepril, Lisinopril, Enalpril,etc.,

Pharmacological aspects:

Lisinopril

Classification:ACE inhibitors

Action:Antihypertensive drugs

Indication:

• Elevated blood pressure
• Congestive heart failure
• Heart attack
• Acute myocardial infarction

Dosage:

Adults:10mg/day as starting dose gradually can be increased to maintain ace dise of 20 to 49 mg .The maximum dose which is recommended is 80mg/day

Pharmacological action

This drug when administered stops the conversion of angiotensin 1 to angiotensin 2 which is responsible for constriction of blood vessel. As a result when this action is stopped the blood vessels dilate and decreasing the blood pressure.It also stops the breakdown taking place in bradykinin which is a vasoconstrictor. This both leads to decrease in blood pressure.

Adverse reactions:

• CNS:dizziness, drowsy, headache
• CVS:arrhythmia, weak pulse,decreased blood pressure
• Gastrointestinal:Nausea vomiting,abdominal discomfort ,anorexia
• Respiratory:cough ,cold ,sneezing, sore throat
• Renal:increased level of BUN ,creatinine, changes in urine pattern,cloudy urine
• Integumentary:rash,muscle weakness
• Others:fever,weight gain ,fatigue ,insomnia

Contraindication

• Hypersensitivity
• Pregnant women
• Breastfeeding mother

Interaction

• When taken potassium supplements
• Insulin
• Diuretics
• NSAIDS

Patient education

• Do not skip dose or underdose or overdose
• Take as prescribed
• Report any adverse reactions
• Avoid potassium rich foods
• Reduce sodium intake
• Follow dietary management
• Regular physical activity