June 1, 2023

Ace-Inhibitors/ARB’s are commonly used to treat heart failure patients. The use of these medications can improve symptoms, reduce hospitalization and prolong life. Beverly Tuomala Heart Failure Nurse Specialist explains Ace-Inhibitors/ARB’s, their side effects, warnings and alternative medications used in treating heart disease.

Alright let’s talk about the next group of drugs the ace inhibitor or the arb the angiotensin converting enzyme inhibitor or the arb are medicines that we typically will use for high blood pressure they live at the amount of angiotensin the body makes and angiotensin makes that arteries of the body get really tight so it makes the blood pressure go up so if we inhibit

It the blood vessels relaxed and the blood pressure goes down we started using these in heart failure and we found that there were huge benefits patients felt better they lived longer and they stayed out of the hospital so all the studies showed that this was a drug that benefitted heart failure patients and it didn’t matter that high blood pressure or not if their

Blood pressure was normal or low we would still start these medicines and we got a benefit of these three things we just talked about symptoms improved hospitalizations reduced and their life was prolonged the ace inhibitors are drugs that you would know as the prell drugs enalopril lisinopril plus and aprill these drugs are now generic they’re cheap you can get five

Dollars a month that hiv or walmart this is lifelong therapy this is a pill that i tell my patients you will never stop unless your heart doctor stops it or a kidney doctor stops it you will remain on this drug tell them at the very end a common side effect of these drugs are a cough and i’m sure you’ve all heard the patients saying if i just start coughing and i

Can’t stop yeah that’s a very common side effect also this drug can make elevation of potassium in the blood stream so it helps with the potassium issue it can cause blood pressures to get too low so we have to really watch these people for low blood pressures and there’s also a another side effect called angioedema and this is more common in our african-american

Population they’ll take an ace inhibitor and when you take an ace inhibitor if that there’s a a release or an accumulation of a chemical called bradykinin that’s what causes the coff that we see but brennan can make african-americans that are very susceptible to it developed this angioedema which is basically swelling around the lips their tongue and their throat

So it can be very dangerous so i would always warn my african-american patients if you start noticing that your lips are getting swollen tingly or the tongue starts to swell you know you need to go to the emergency room and stop this medication so if a patient can’t tolerate the ace inhibitor because they’ve developed a cough they’ve developed angioedema we use the

Angiotensin receptor blocker an arb and they work the same they both inhibit the renin-angiotensin system just what doesn’t have the side effects so you’re a arby’s are there losartan the valsartan the candesartan you would probably recognize them more as kosar and diovan and again these can be used interchangeably we typically will start with one of the pearl drugs

One of the ace inhibitors and if they don’t tolerate then we’ll move to vit the arb a word of caution to using these two drugs whether it’s the ace inhibitor or the arb is you need to tell your patients to avoid use of any of the anti-inflammatory drugs those are your ibuprofen your advil your leave motrin when you take those drugs on top of an ace inhibitor or an

Arb it interferes with the benefit of the drug so we tell our patients do not take the two together it can cause the heart failure to get worse by causing fluid retention it can also cause a renal injury so unfortunately our patients with arthritis and aches and pains you know tylenols prai the safest vet for them but always reinforce do not take aleve motrin advil those type of drugs

Transcribed from video
Living with Heart Failure: ACE Inhibitors/ARB's By mmlearn.org