ACE inhibitor
Angiotensin-converting enzyme inhibitor
- Blocks angiotensin I → angiotensin II
- Vasodilation → ↓ BP
- Renal protection
- Bradykinin accumulation → dry cough/angioedema
- ↓ aldosterone → hyperkalemia
- Blocks conversion of angiotensin I to angiotensin II
- ➔ vasodilation, reduced blood pressure, renal protection
- Dry cough from bradykinin accumulation
- Hyperkalemia and angioedema; contraindicated in pregnancy
Drugs with this mechanism (10)
- Benazeprilat — Active ACE-inhibiting metabolite of benazepril; lowers blood pressure but can raise potassium and creatinine.
- Captopril — The first ACE inhibitor; short-acting, sulfhydryl-related dysgeusia.
- Enalaprilat — The only intravenous ACE inhibitor; used when oral antihypertensive therapy is impossible.
- Fosinoprilat — Active ACE-inhibiting metabolite of fosinopril; combined renal and hepatic elimination distinguishes it from most ACE inhibitors.
- Lisinopril — Active ACE inhibitor for hypertension and heart failure; cough and angioedema matter.
- Moexipril — Older ACE-inhibitor prodrug for hypertension; food markedly reduces absorption.
- Perindoprilat — Active ACE-inhibiting metabolite of perindopril; renally cleared, with hyperkalemia and kidney-function risks.
- Quinaprilat — Active ACE-inhibiting metabolite of quinapril; renal impairment prolongs exposure, increasing hypotension and hyperkalemia risks.
- Ramiprilat — Active ACE-inhibiting metabolite of ramipril; prolonged ACE binding sustains effects, while renal impairment increases exposure.
- Trandolaprilat — Active ACE-inhibiting metabolite of trandolapril; prolonged ACE binding supports sustained blood-pressure lowering.
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