ACE INHIBITORS & ARB-COMPLICATIONS

SUMMARY

1. Complications of ACEls include an increase in serum K⁺ & decrease renal function.

2. Use with caution in bilateral renal artery stenosis, heart failure, polycystic kidney disease, and hypertensive nephrosclerosis because the ACEI decreased GFR can precipitate AKI.

3. Up to 20% of patients have to stop an ACEI because of cough.

4. Angioedema is a possible fatal side effect.

5. ARBs have a lower incidence of angioedema and cough.

6. ACEIs/ARBs are absolutely contraindicated in pregnancy because they are teratogenic.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].