All of the following are the indications for use of ACE inhibitors, except-
Correct Answer: Pheochromocytoma
Description: Ans. is 'd' i.e., Pheochromocytoma Uses of ACE inhibitor I) Hypeension ? o The antihypeensive effect of ACE inhibitor results primarily from vasodilatation. o A decrease in aldosterone production may also contribute to antihypeensive effect. o ACE inhibitors are now the first line drugs in all grades of hypeension (About 50% of patients respond to monotherapy) o ACE inhibitors are most useful in hypeension when the raised blood pressure results from excess renin production (renovascular hypeension) II) Cardiac failure ? o In hea failure there is excessive activation of renin angiotensin aldosterone system. o ACE inhibitors abolish the effect of angiotensin II (vasoconstriction, aldosterone secretion and, Na+ & water retention) by preventing conversion of AT-I to AT-II. o Multicentric trials have shown that ACE inhibitors retard the progression of left ventricular systolic dysfunction and prolong survival of CHF patients of all grades (I to IV) (they reduce moality). o Unless contraindicated ACE inhibitors are now advocated as first line drugs in all patients with symptomatic as well as asymptomatic left ventricular inadequacy. 111) Diabetic nephropathy - o ACE inhibitors have a specific renoprotective effect because Angiotensin II is the main factor responsible for pathological changes. o Prolonged ACE inhibitor therapy has been found to prevent or delay end stage renal disease in type I as well as type II diabetics. o ACE inhibitors are the first line drug for hypeensive type I diabetics. There is also evidence that ACE inhibitors have a proteinuria-sparing effect in type I diabetics with normal B.P. o All patients with diabetic nephropathy, whether hypeensive or normotensive deserve ACE inhibitor therapy. o AT-II antagonists have better renoprotective effect in type 2 DM with nephropathy. IV) Myocardial infarction ? o Following MI, the LVF may occur from the loss of functional tissue or from a process of remodelling of the scarred ventricular wall. o Angiotensin II plays a key role in both these processes. o ACE inhibitors given after M.I. markedly reduce the incidence of hea failure. V) Scleroderma crisis ? o ACE inhibitors cause dramatic improvement in patients of scleroderma crisis with marked rise in B.P. and deterioration in renal function. VI) Prophylaxis in high cardiovascular risk subjects o ACE inhibitors tilt the fibrinolytic balance towards a profibronolytic state by reducing plasma levels of plasminogen activator inhibitor - 1.
Category:
Pharmacology
Get More
Subject Mock Tests
Practice with over 200,000 questions from various medical subjects and improve your knowledge.
Attempt a mock test nowMock Exam
Take an exam with 100 random questions selected from all subjects to test your knowledge.
Coming SoonGet More
Subject Mock Tests
Try practicing mock tests with over 200,000 questions from various medical subjects.
Attempt a mock test now