ACE Inhibitor Side Effects | Ramipril, Enalapril, Captopril, Perindopril | Causes and Why They Occur
In this lesson we are talking about the side effects of ace inhibitors so we’re going to talk about what ace inhibitors are we’re going to talk about some of the examples of ace inhibitors and we’re also going to talk about the side effects of ace inhibitor use so ace inhibitors or angiotensin converting enzyme inhibitors are medications that are used to reduce
Blood pressure and aid in reducing protein ore they have some other functions as well including some effects on heart health so they can be used in a variety of different patient populations including hypertension patients kidney disease patients and diabetes patients including some other heart failure patients as well and these medications all end in the
Suffix prill so we can see in this example here we have ramit pearl that is one of the ace inhibitors analopril is another example captive pro is another example and perindopril is another example and they act by inhibiting the formation of angiotensin ii and as is in their name they are angiotensin converting enzyme inhibitors so they inhibit an enzyme known
As ace or angiotensin converting enzyme this enzyme converts angiotensin 1 into angiotensin ii it has some other effects including breakdown of something known as bradykinin or bradykinin and we’ll talk about why this is important and why i bring this up in the next slide but what’s important here is that they prevent the production of angiotensin ii which is a
Potent vasoconstrictor or constricts blood vessels so it increases blood pressure so it prevents the production of angiotensin ii but the problem is that ace inhibitor use may cause a variety of mild and severe symptoms we’re going to talk about those symptoms in the next upcoming slides so what are some of the side effects of ace inhibitor use one of the common
Side effects of ace inhibitor use is a dry hacking cough this is known as an ace inhibitor induced cough and the reason why ace inhibitors can cause a dry cough is because ace inhibitors prevent the degradation of bradykinin as we mentioned in the last slide the angiotensin-converting enzyme degrades bradykinin but if we’re inhibiting that enzyme we’re going to
Inhibit the degradation of bradykinin leading to increased levels of bradykinin and increased levels of bradykinin in the lungs in particular may induce coughing and again as i mentioned before this is a relatively common side effect that may affect anywhere from zero percent of patients to upwards of 44 of patients another side effect of ace inhibitor use is
Something known as angioedema so this is a severe side effect it is swelling of the tongue and lips so it’s a serious severe side effect that may cause issues with respiration you can imagine that if your tongue or your lips start to swell you may have occlusion of your airways you may not be able to breathe or swallow properly so this can be a big issue there
Can also be angioedema of the intestines which occurs more commonly in women that can lead to abdominal pain and diarrhea it’s less common but it can occur as well so this side effect of angioedema can lead to swelling of the tongue and lips and it can also lead to a swelling of the intestines leading to abdominal pain and diarrhea most often what happens is that
Patients will have some mild episodes of angioedema over time they may not think much of it and then they may have an episode where it becomes very severe requiring a visit to the hospital so that’s what most commonly will occur in patients who get this side effect another side effect of ace inhibitor use is high potassium levels this is known as hyperkalemia
So high potassium levels in the blood and it’s because these inhibitor use causes the kidneys to hold on to potassium so we can get hyperkalemia or high potassium from ace inhibitor use this can lead to some symptoms of high potassium including muscle weakness nausea vomiting and diarrhea and even cardiac arrhythmias so if you want more information on signs and
Symptoms of hyperchlamy please check out my lesson on that topic we can also see fatigue occurring in ace inhibitor patients this is a side effect as well this can be related to hyperkalemia so hyperchlamy can cause muscle weakness but also some fatigue and this may be related with ace inhibitor use we can also see skin rashes occurring with ace inhibitor use
Multiple varieties of skin lesions can occur this is a drug induced eruption we can see bulla or bolus presentations and we can also see pruritic urticaria so pruritic means they are itchy urticaria are hives so there can be itchy hives that can occur as well and this can most commonly occur with captopril so these skin rashes more commonly occur with captiprill
And we can also see some photosensitivity occurring as well so some sensitivity to the sun or sunlight another side effect of ace inhibitor use is hair loss so some hair loss may occur with ace inhibitor use although this is a rare side effect so can occur with use of any of the ace inhibitors but again it’s quite rare may occur in roughly one percent of patients
Another side effect of a sniper use is reduced sense of taste now this is a more distortion or disturbance of taste so their ability to taste certain types of flavors may be altered or affected so this can be subtle or can be quite noticeable and again this is most commonly seen with captopril and then because ace inhibitors lower blood pressure we can have
Issues with hypo tension or a low blood pressure so this can be due to a first dose phenomenon so the first time a patient starts to use ace inhibitors they may have lower blood pressure than is what is wanted or desired but it may occur any time during use and though this can most often occur when patients are dehydrated if they’re exercising they’re sweating a
Lot or in some other types of patients including congestive heart failure patients so this is more common in those types of situations basically this means that there is too much ace inhibitor mediated action so this can cause hypertension and it can lead to signs and symptoms of hypertension including pre-syncope which is a feeling of light-headedness there can
Be syncope in some cases where a patient may faint and there can be some other symptoms as well including weakness and fatigue so some of these are some signed symptoms of hypertension that can occur with ace inhibitor use as well and we can also see issues with anemia with asymmetry use this is low level of red blood cells it’s because ace inhibitors can inhibit
Erythropoietin erythropoietin is the hormone that stimulates your bone marrow to produce red blood cells so this can lower the production of red blood cells leading to a low level of red blood cells and anemia and anemia can lead to a variety of symptoms and some of these include fatigue as well so again ace inhibitors can lead to anemia although this is an
Uncommon side effect and another uncommon side effect is leukopenia leukopenia means a low level of white blood cells so this is or may be a rare side effect there are some case reports of this occurring having low levels of white blood cells but it seems to be rare and in that case if there are low levels of white blood cells particularly white blood cells like
Neutrophils or maybe an increased risk of infections so again a lot of these side effects we’re talking about here are rare or uncommon some of the ones that we talked about earlier are more common but again most of these are uncommon side effects if you want to learn more about other medications and their side effects please check out my pharmacology playlist
And if you haven’t already please like and subscribe for more lessons like this one thanks much for watching and i hope to see you next time
Transcribed from video
ACE Inhibitor Side Effects: Lisinopril, Ramipril, Captopril, Perindopril | Causes and Why They Occur By JJ Medicine
