ACE inhibitors which of the following is true
|A||These inhibit the conversion of angiotensinogen to angiotensin-1|
|B||Omission of prior diuretic dose decreases the risk of postural hypotension|
|C||Lisinopril is shorter acting than enalapril|
|D||These are contra-indicated in diabetic patients|
a. ACEI inhibit the conversion of AT – I to AT – II.
b. The drugs which prevent conversion of Angiotensinogen to AT- I are direct renin inhibitors like aliskiren and remikiren. (OPTION A.)
c. 1st dose hypotension is a one of the side effect of ACEI seen; they being powerful arteriolar dilators.
d. It is commonly seen in patients suffering from CHF & those, which are on vigorous diuretic therapy. Thus to avoid this effect; diuretics should be omitted. (OPTION B).
e. Enalapril is less longer acting than lisinopril; though both can be given OD. The duration of action of enalapril is 24 hrs while that for lisinopril is more than 24 hrs. The elimination half-life is 11 & 12 hrs respectively. (OPTION C.)
f. They are indeed, one of the first drugs to be given in systolic dysfunction. (OPTION D).
g. ACE inhibitors are the drug of choice (Dhikav V, Drugs of choice’ 2011, 5th Edition):
i. Diabetes with hypertension
ii. Nephropathy wit hypertension
v. Reno vascular hypertension
vi. Unilateral renal artery stenosis
· These drug improve left ventricular dysfunction hence are the front like drugs in CHF