Angiontensin Converting Enzyme inhibitors or ACE inhibitors are a group of medicines that are said to have been historically developed from the venom of a poisonous snake found in Brazil. Nowadays this wonder drug can easily be prepared in laboratories. It is mainly used in the treatment of hypertension and disorders related to the kidney and the heart.
Formation and Metabolism:
ACE Inhibitors work on the lungs and helps to prevent the conversion of a particular enzyme from its inactive to its active form. These if activated lead to the constriction of the blood vessels, the “arterioles”, which causes the blood pressure to rise thereby resulting in hypertension. Therefore, ACE inhibitors mainly prevent the constriction of the blood vessels thereby improving the blood flow and thus reducing hypertension.
Technically speaking, renin an enzyme from the kidney combines with angiotensinogen a protein present in the blood to form “angiotensin-1” an inactive decapeptide. This angiotensin-1 passes through the lungs and other tissues and is converted into an octapeptide “angiotensin-2” by the action of another enzyme Angiotensin Converting Enzyme (ACE). That is ACE inhibitors block the conversion of angiotensin-1 to angiotensin-2.
Types of ACE Inhibitors:
There are various types of ACE inhibitors. The most commonly prescribed are Captopril, Enalapril, Benazepril, Lisinopril, Quinapril, Ramipril, Fosinopril, Moexipril, Perindopril, Trandolapril etc.
Breakthroughs in medicine have brought about different types of drugs that act at different levels. Some of them are listed below:
1. At the primary synthesis level, there are medicines that prevent rennin from generating angiotensin-1. For example: Enalkiren
2. At the second stage, that is the conversion level ACE inhibitors such as Captopril and Enalapril prevent the conversion of angiotensin-1 to angiotensin-2.
3. Advanced medical research has led to the development of medicines which prevent the action of angiotensin-2 at the receptor levels. For example: Saralasin, Losartan.
Drug Interactions from ACE Inhibitors:
Specific care should be taken if the ACE inhibitors are taken along with other drugs. Diuretics if consumed along with ACE inhibitors can cause “drug interactions” which can result in adverse reactions. Similar reactions can be seen when these are taken along with drugs like ibu profen or aspirin. Additionally the consumption of alcohol is not advisable when a person is under this treatment. Likewise potassium pills and other dietary supplements should be avoided during its administration. ACE inhibitors should be discontinued on the onset of pregnancy and is not recommended for breast feeding mothers.
Side effects from ACE Inhibitors:
Although ACE inhibitors are extremely useful they are not without side effects. One of the most common side effects of these drugs is the occurrence of dry cough. Reducing the dosage is the routine followed by the doctors in this case. Dizziness is another dilemma faced by first time users. Some of the other side effects are headache, diarrhoea, numbness, swelling of the lips or tongue, feeling of tiredness, joint pain, loss of appetite and fever.
Extreme caution should be exercised in the case of patients who have had a history of heart and kidney disorders associated with ACE Inhibitor therapy. Dehydration is another factor that should not be overlooked when administering ACE Inhibitors.
In conclusion it can be rightly said that ACE Inhibitors are an effective treatment in the case of heart and kidney diseases. Though advances in medical breakthrough have brought with it a variety of new drugs that surpasses the use of ACE Inhibitors, it is still widely used in the field of medicine. If properly administered this wonder drug can aid in the proper functioning of the heart.
