Angiotensin-converting enzyme inhibitors side effects

Angiotensin-converting enzyme inhibitors are effective in the treatment of hypertension and congestive heart failure. ACE inhibitors also prevent bra-dykinin metabolism and, as a result, may produce the side effect of cough and angioedema. Many of the known ACE inhibitors were developed without the aid of computational chemistry techniques. However, a number of studies have used computational methods to design mimics of other nonpeptidic ACE inhibitors. 

Adverse drug reactions many drugs can cause gastrointestinal disturbance as a side-effect. Those most commonly associated with indigestion include angiotensin-converting enzyme inhibitors... 

Adverse drug reactions drugs that can produce cough as a side-effect include angiotensin-converting enzyme inhibitors, non-steroidal anti-inflammatory drugs and beta-blockers. 

Celecoxib is currently indicated for the relief of signs and symptoms of osteoarthritis and rheumatoid arthritis and to reduce the number of adenomatous colorectal polyps in familial adenomatous polyposis as an adjunct to usual care. Celecoxib is at least as effective as naproxen in the symptomatic management of osteoarthritis and at least as effective as naproxen and diclofenac in the symptomatic treatment of rheumatoid arthritis, and it is less likely to cause adverse Gl effects. Celecoxib appears to be effective in the management of pain associated with both of these arthritic conditions, but effectiveness in acute or chronic pain has not been fully demonstrated. Unlike aspirin, celecoxib does not exhibit antiplatelet activity. Concomitant administration of aspirin and celecoxib may increase the incidence of Gl side effects. Another notable potential drug interaction with celecoxib is its ability, like other NSAIDs, to reduce the blood pressure response to angiotensin-converting enzyme inhibitors. A more detailed discussion of the chemical, pharmacological, pharmacokinetic, and clinical aspects of celecoxib is available (81). 

Angiotensin-converting enzyme (ACE) inhibitors such as captopril exert a long-term reno-protective effect. Among other effects, they lower systemic blood pressure and renal plasma flow and effectively reduce urinary protein excretion. Renal delivery of ACE-inhibitors may increase this efficacy and reduce extra-renal side-effects. Renal targeting of an ACE-in-hibitor can also be useful in clarifying the contribution of local ACE inhibition to these reno-protective effects. 

Hyperkalaemia, not surprisingly, is the most important side effect of these drugs and can be dangerous in patients who are taking K-i- supplements or other K-i--sparing diuretics. Concomitant use of angiotensin-converting enzyme (ACE) inhibitors and NSAIDs can also exacerbate hyperkalaemia. 

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