# ACE Inhibitors --- **ACE inhibitors** (angiotensin converting enzyme inhibitors) are a type of [[medicine]] that are used to treat [[hypertension]] and [[heart failure]]. It stops [[coronary artery disease#Remodeling|negative remodeling]], I think, so it's given to patients after they have a [[percutaneous coronary intervention|stent]] put in. Greater efficacy for [[heart failure]], first line defense. reduces afterload, reduces cardiac remodeling after MI, and is used to treat dilated cardiomyopathy? ## Mechanism of Action ACE inhibitors inhibit the [[renin-angiotensin-aldosterone system|ACE]] enzyme in the [[renin-angiotensin-aldosterone system|RAAS]] system, so angiotensin I never gets converted to angiotensin II. Angiotensin triggers two responses: vasoconstriction and the retention of water, so the ACE inhibitors essentially cause vasodilation and the loss of water in the urine. ACE works by reabsorbing [[sodium]], which means that ## Adverse Reactions - angioedema - this is a rare but severe reaction - subcutaneous swelling - especially in the lips and tongue, but it's not usually that obvious - this is be pretty dangerous, because it can happen all over, like the GI tract - dry cough - benign, but often very annoying and makes people feel self conscious - sometimes they're switched to an [[angiotensin receptor blockers|ARB]] if the cough is too much - hypotension - taste disturbances - leaves a bitter taste - [[hyperkalemia]] - due to the lack of ALDO sodium is being excreted, and potassium is retained - make sure to avoid combining ACE inhibitors and anything potassium-sparing (like spironolactone) - [[teratogen|teratogenic]] ## Meds The trade names all end in -pril. - **Lisinopril** (brand name: **Prinivil**, **Zestril**) - **Enalapril** (brand name: **Vasotec**) - **Captopril** (brand name: **Capoten**) ___