Pharmacology of ACE inhibitors , mechanism of action , uses and side effects

ACE INHIBITORS

Introduction

ACE inhibitors are among the most widely prescribed cardiovascular medicines.

The ACE inhibitors are -

• Raipril
• Lisinopril
• Perndoprol

ACE inhibitors are used in the treatment of the following conditions :

• Hypertension - ACE inhibitors reduce the risk of serious cardiovascular events, such as heart attack and stroke. they may be used first or second line, usually usually in combination with another drugs.
• Ischemic heart disease - as with hypertension, the purpose of ACE inhibitors is to reduce the risk of heart attack and stroke.
• Chronic heart failure - used for the symptomatic treatments of heart failure, improving overall prognosis for the patients.
• Diabetic nephropathy - ACE inhibitors can be used to prevent nephropathy from progressing in diabetic patients. They may also be used for chronic kidney disease ( with proteinuria ) to reduce proeinuria.

ACE inhibitors are, then , an important class of cardiovascular medicines that play a significant clinical role hypertension, heat disease and kidney comlications.

Mechanism of action

The fundamental mechanism of ACE inhibitors pharmacology involve blocking the effect of ANGIOTENSIN CONVERTING ENZYME. The ACE enzyme is is predominantly found on the surface pulmonary and renal epithelia.

This enzyme is responsible for converting angiotensin I (ATI) to angiotensin I (ATI) Angiotensin I is itself produced from

angiotensinogen, a globular protein released from the liver in response to renin release from the kidney.

To summarize:

Renin is released from the juxtaglomerular apparatus of the

kidney in response to electrolyte and/or water imbalances in the body:

Low sodium levels

Low blood pressure

Decreased blood volume

 Renin cleaves angiotensinogen intoATI.

Angiotensin-converting enzyme turns ATI into ATII.

Why is reducing angiotensin II levels important ?

• ATII stiulates the release of aldosterone from the adrenal cortex.
• In turn, aldosterone promotes reabsorption of sodiu and chloride ions, increasing water retention. During this process, potassium is also excreted.
• Vasoconstriction; increasing blood pressure.
• ADH secretion from posteriour lobe of the pituitary gland, prooting water retention from the collecting ducts.

ACE inhibitors, by preventing produvtion of ATII, has the following effects :

• Prevent aldosterone release from the adrenal cortex.
• Elimination of sodium ions ( and increased water loss ) from the kidney.
• Potassium ions are retained.
• Consequent reduction in blood volume and blood pressure

ACE inhibitors pharmmacolgy is dependent upon the cessation is dependent upon the