Potential Health Risks from Inappropriate Prescription of...

Learning Goals 1) Locate where in the renin-angiotensin-aldosterone pathway ACE inhibitors act 2) Identify commonly prescribed antihypertensive medication by primary care physicians 3) List 3 possible side effects from inappropriate ACE inhibitor prescription 4) Suggest possible regulations of ACE inhibitor use for primary care physicians and alternative treatment plans for patients Introduction Cardiac related diseases account for over 56 million annual deaths worldwide.1 Cardiovascular disease (CVD) is the leading cause of death in economically developed countries and is increasing in occurrence in developing nations.1 The prevalence of CVD increases with age.1 The mean level of blood pressure, used to diagnose CVD, is higher in†¦show more content†¦She has been smoking a pack of cigarettes per day for the past 20 years. She has admitted to occasional alcohol use. She is allergic to the commonly prescribed antibiotic penicillin. Biochemical Mechanisms of ACE Inhibitors The renin-angiotensin-aldosterone system (RAAS) is a group of hormones that are produced sequentially in order to regulate salt-water homeostasis as well as blood pressure.5 The first enzyme, renin, is produced by the juxtaglomerular cells of the kidney when blood volume is low and is released into the bloodstream.3,5,6 Renin then catalyzes the conversion of angiotensinogen to angiotensin I.3,5,6 Angiotensin-converting enzyme (ACE), which is produced in the lungs, subsequently converts angiotensin I to angiotensin II, a more active enzyme.3,5,6 Angiotensin II has several functions. The hormone’s primary mechanism for increasing blood pressure is through the stimulation of blood vessel constriction. Furthermore, angiotensin II increases the contractility of the heart via sympathetic activation. It also stimulates anti-diuretic hormone (ADH) release, which increases water reabsorption at the collecting ducts, resultingShow MoreRelatedWhat is Polypharmacy?2471 Words   |  10 P agesPolypharmacy is generally defined as the use of multiple prescription and/or over-the-counter medications simultaneously. â€Å"The incidence of risk for adverse drug events, reactions, and interactions increases proportionately with the number of drugs taken, such that the use of five or more compounds increase risk for adverse drug events to more than 50% while the use of seven or more drugs results in a risk of more than 80% (Heuberger, 2012).† Having multiple prescribers, different filling pharmaciesRead MoreCase Study Essay33967 Words   |  136 PagesEmergency department, hospital Index Words: heart failure (HF), cardiomyopathy, volume overload, quality of life X Scenario M.G., a â€Å"frequent flier,† is admitted to the emergency department (ED) with a diagnosis of heart failure (HF). She was discharged from the hospital 10 days ago and comes in today stating, â€Å"I just had to come to the hospital today because I cant catch my breath and my legs are as big as tree trunks.† After further questioning, you learn she is strictly following the fluid and salt