Enalapril use is not advisable in the following conditions except
Correct Answer: Diabetic nephropathy with albuminuria
Description: ACE inhibitors (e.g. enalapril 20 mg daily, ramipril 5-10 mg daily or lisinopril 10-40 mg daily). These inhibit the conversion of angiotensin I to angiotensin II and are usually well tolerated. They should be used with paicular care in patients with impaired renal function or renal aery stenosis because they can reduce the filtration pressure in the glomeruli and precipitate renal failure. Electrolytes and creatinine should be checked before and 1-2 weeks after commencing therapy. Side-effects include first dose hypotension, cough, rash, hyperkalaemia and renal dysfunction. ref:davidsson&;s principles and practices medicine,21 st ed,pg no 609
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