Captopril, high blood pressure

You will know people (probably older men) who are on fi-blockers . These are compounds designed to block the effects of adrenaline (epinephrine) on the heart and hence to prevent heart disease. One of the best is Zeneca s tenormin. Preventing high blood pressure also prevents heart disease and certain specific enzyme inhibitors (called ACE-inhibitors ) such as Squibb s captopril work in this way. These are drugs that imitate substances naturally present in the body. 

We have already met proline 6 and its structure is clearly contained in the Bristol-Meyers Squibb ACE inhibitor captopril 123. In other cases the relationship is not so obvious. Other ACE inhibitors, also used to treat high blood pressure, such as ramipril 124 and fosinopril 125, also contain the elements of proline but it is not obvious how we should use that observation. 

Angiotensin-converting enzyme (ACE) inhibitors are used for the treatment of high blood pressure, and were designated using the carboxypeptidase structure as a model for Zn " protease action. Captopril is a small, potent, orally available, dipeptidyl inhibitor of ACE. 

The commercially most successful zinc(II) carboxylase inhibitors include captopril (1), enalapril (2a), enalaprilat (2b) (the diacid metabolite of 2a), and trandolapril (3).i55-i58,i60-i62 or structures of these drugs, see Scheme 15. They all act against the ACE that converts angiotensin I to angiotensin II. These compounds have been used for years as successful orally active drugs to reduce high blood pressure by decreasing the ACE activities that play a major role in the... 

The client diagnosed with high blood pressure is ordered the angiotensin-converting enzyme inhibitor captopril (Capoten). Which statement by the client indicates to the nurse that the discharge teaching has been effective ... 

Captopril was approved in 1982 by the FDA for the treatment of high blood pressure. One year later followed the approval for treatment of heart failure, and finaUyin 1994, the drug received approval fortreatment of kidney disease caused hy Diabetes mellitus. 

Some of the common drugs used in human medicine (e.g., aspirin) (Section 18.5B) are achiral. Others are chiral and sold as single enantiomers. The penicillin and erythromycin classes of antibiotics and the drug capto-pril are aU chiral drugs. Captopril, which is very effective for the treatment of high blood pressure and conges-... 

Low-dose aspirin (less than or equal to 100 mg daily) does not alter the antihypertensive efficacy of captopril and enalapril. No special precautions would therefore seem to be required with ACE inhibitors and these low doses of aspirin. A high dose of aspirin (2.4 g daily) has been reported to interact in 50% of patients in a single study. Aspirin 300 mg daily has been reported to interact in about 50% of patients in another study, whereas 325 mg daily did not interact in further study. Thus, at present, it appears that if an ACE inhibitor is used with aspirin in doses higher than 300 mg daily, blood pressure should be monitored more closely, and the ACE inhibitor dosage raised if necessary. Intermittent use of aspirin should be eonsidered as a possible cause of erratic control of blood pressure in patients on ACE inhibitors. 

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