ACE AND ARBS (PART 2)

USES
Used in the management of mild to severe hypertension.
Decrease cardiac after load, increase COP and reduce the risk of death in HF patients.
Also used in hypertensive diabetic nephropathy .
Captopril- shorter half life and must be given 2 – 3 times a day .


INTERACTION
Anti hypertensive action is augmented by diuretics and several combinations are available.
It interact with potassium sparing diuretics and cause increase in potassium level and it should not be given in this situation .
Increase serum lithium level and provoke lithium toxicity .
NSAID – ( brufen ) impede the effects of ACE inhibitors.


ADVERSE EFFECT
Dry unproductive cough
Altered taste , hyperkalcemia and fetotoxic and rashes on the body.

ARBS
ARBs block AT1receptors in vascular smooth muscles and adrenal cortex, there by causing vaso dilation and decrease aldosterone secretion
 it does not increase bradykinin level .
Decrease nephro toxicity – attractive medicine in hypertensive diabetes .
Losartan used to decrease LVH.
Orally effective
Decrease incidence of dry cough , feto toxic , hperkalemia
neutropenia .