Angiotensin-Converting Enzyme Inhibitors & Angiotensin Receptor Blockers
Constructive Criticism
When discussing Angiotensin Receptor Blockers (ARB)and Angiotensin-Converting Enzyme Inhibitors (ACE), there is a need to emphasize peripheral vascular resistance as an issue two medications address. The mode of action of the two drugs was accurate as it helped present the systemic vascular resistance. It is valid to state that both the systemic vascular resistance ARBs and ACEs help lower systemic vascular resistance ( Valera et al., 2020 ). This paper effectively presented the description, indications, routes of administration, side effects, and examples of the drugs. Having considered the side effects of ARB and ACE, it would be essential to introduce the contraindications because they serve as critical concerns when administering the drugs.
Angiotensin-Converting Enzyme Inhibitors (ACE Inhibitors)
Angiotensin-Converting Enzyme Inhibitors fall under the pregnancy category D. This category indicates that there is enough information showing severe fetal consequences whenever a pregnant mother takes the medication ( Herman et al., 2020 ). This information in the contraindications section was adequate in showing that pregnant women have to inform doctors about their situation before taking the drugs. Whenever healthcare professionals administer drugs like enalapril, they should ask for such information to guarantee fetal safety. Patients who take the drug may have to seek a change of the drug when they become pregnant.
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Conditions such as renal failure and hyperkalemia are also critical concerns for the use of ACE inhibitors. Patients with high potassium levels in their circulatory system should not use the drug because it causes further increases ( Herman et al., 2020 ). It is also appropriate to ensure patients taking ACE inhibitors do not have renal failures. Kidneys have a role in ensuring there is complete clearance of a drug from the body. When patients have the disease, they may tend to increase the rate of ACE inhibitors’ clearance. Such a situation may prevent the drugs from being effective. Provision of this information serves best both patients and their doctors in understanding people who need to avoid the medications.
Angiotensin Receptor Blockers (ARBs)
The paper also involves statements like those that consider it not appropriate to have people who do not use ACEs use ARBs. This argument is factual; however, it would be appropriate to discuss it under the contraindications section. Patients who use the two drugs may increase the effectiveness, resulting in a life-threatening hypotensive situation ( Patten & Abeywardena, 2017) . The drug also falls under the pregnancy category D. Research shows that ARBs result leads to perfusion of the kidneys of a fetus; they also introduce deformities of the fetal skeleton and prevent renal system formation ( Patten & Abeywardena, 2017 ). When doctors are aware of such severe implications, they will always consider them before administering the drug. Adding such a cautious matter in the side effect section might not make people understand its severity.
Renal failure and hyperkalemia are also critical issues to mention under the contraindications section. The prescribing and dispensing professionals need to ask patients about any history of either acute or chronic kidney failure because it may hinder the availability of the drug at its site of action ( Patten & Abeywardena, 2017) . Doctors also need to consider testing for issues like leukopenia and vasculitis because they prevent ARBs from being functional.
In general, the use of description, indications, routes of administration, side effects, and examples in elaborating about the uses and impact of ACEs and ARBs was effective. However, the use of indications could have made the paper more understandable. This criticism leads to the understanding that contraindications do not fall under the side effects because of their severity. There was a need to have such cautious matters under the contraindications section. Mixing side effects with contraindications is a move that can result in healthcare providers and patients not taking them seriously.
References
Herman, L. L., Padala, S. A., Annamaraju, P., & Bashir, K. (2020). Angiotensin-converting enzyme inhibitors (ACEI). StatPearls [Internet] . https://www.ncbi.nlm.nih.gov/books/NBK431051/
Patten, G. S., & Abeywardena, M. Y. (2017). Effects of antihypertensive agents on intestinal contractility in the spontaneously hypertensive rat: angiotensin receptor system downregulation by losartan. Journal of Pharmacology and Experimental Therapeutics , 360 (2), 260-266. https://jpet.aspetjournals.org/content/360/2/260.abstract
Valera, P., Letuka, P., Mathenjwa, N., & Ntusi, N. A. (2020). Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, mineralocorticoid receptor antagonists, and SARS-CoV-2 infection. SA Heart , 17 (3), 352-361. https://journals.co.za/doi/abs/10.10520/ejc-saheart-v17-n3-a16
