ACE Inhibitors: Nursing Pharmacology Study Guide

ACE inhibitors are a foundational class of cardiovascular medications used to treat hypertension, heart failure, and protect the kidneys in diabetes. This guide highlights the drugs, mechanism, side effects, and nursing considerations most likely to appear on exams.

Drug Identification

Mnemonic: ACE inhibitors end in -pril.

Indications

• Hypertension
• Heart failure
• Post-myocardial infarction
• Diabetic nephropathy

Mechanism of Action

• Blocks conversion of angiotensin I to angiotensin II
• Causes vasodilation
• Decreases aldosterone secretion
• Lowers blood pressure and reduces cardiac workload

Common Side Effects

Life-Threatening Adverse Effects

• Angioedema (swelling of face, lips, tongue) — medical emergency
• Severe hypotension
• Acute kidney injury

Labs to Monitor

Nursing Safety Rules

• Check blood pressure before administration
• Hold the medication if the patient is hypotensive
• Monitor potassium levels regularly
• Contraindicated in pregnancy
• Educate the patient about dry cough and signs of angioedema

Common Exam Traps

• Confusing ACE inhibitors with ARBs (-sartans)
• Ignoring a persistent dry cough
• Giving ACE inhibitors with potassium supplements or potassium-sparing diuretics
• Failing to recognize angioedema early
• Forgetting the pregnancy contraindication

Key takeaways

• ACE inhibitors end in -pril and lower blood pressure while protecting the kidneys.
• Dry cough is common; angioedema is a life-threatening emergency.
• Monitor potassium, BUN, and creatinine closely.
• Hold the dose for hypotension and check BP before each administration.
• Never give ACE inhibitors during pregnancy.
• Do not combine with potassium supplements or potassium-sparing diuretics without close monitoring.