ACE Inhibitors (Angiotensin-Converting Enzyme Inhibitors): A Complete Pharmacology Guide for Pharmacy Exams

What are ACE Inhibitors?

ACE inhibitors are a group of medications that are primarily used to treat hypertension (Blood pressure) and heart failure. They work by relaxing blood vessels, which reduces the workload on the heart. ACE inhibitors act on Renin-Angiotensin-Aldosterone-System (RAAS) to lower the blood pressure and reduce the strain on kidney and heart.

They are mainly used to treat conditions like:

• Hypertension

• Heart failure

• Chronic kidney disease(CKD)

• Post-Myocardial Infarction (MI)

• Diabetic nephropathy

These widely prescribed and frequently tested in pharmacy licensing exams such as OPRA (Australia), PEBC (Canada), PSI (Ireland), FPGEE (USA), etc

What is the mechanism of action of ACE inhibitors?

ACE Inhibitors block the action of the ACE (Angiotensin Converting Enzyme which is involved in the production of Angiotensin II, which is a potent vasoconstrictor.

By inhibiting the action of this enzyme:

• ACE Inhibitors reduces production of Angiotensin II leading to less vasoconstriction

• It decreases the production of Aldosterone, thus causes lower sodium and water retention in body

• It will increase bradykinin which will increase the vasodilation. (But causes dry cough)

Net result of these actions are :

• Lower blood pressure

• Improved cardiac output due to reduced preload and afterload

• Reduced renal damage in diabetics

• Decreased preload and afterload in heart failure

Common ACE Inhibitors: At a Glance

Most ACE Inhibitors end in “PRIL”. Captopril is notable for its sublingual use in hypertensive emergencies

What are the common uses of ACE Inhibitors?

What are the common side effects of ACE Inhibitors?

• Dry cough: This is most common, affecting the majority of patients due to bradykinin buildup due to the mechanism of action. The cough can be persistent and may be more noticeable at night or when lying down.

• Dizziness and Lightheadedness: mainly occurs when the therapy is started or the dose is increased. And may be more pronounced when standing up quickly.

• Headache: commonly seen

• Fatigue and weakness: some patients can feel tiredness

• Taste disturbance: a metallic taste or loss of appetite

• Gastrointestinal issue: Nause, stomach upset, diarrhea, or constipation may occur

Less common side effects are:

• Angioedema

• Kidney problems

• Hyperkalemia

• First-dose hypotension

Mnemonic for Side effects of ACE Inhibitors-CAPTOPRIL

Common Drug interactions with ACE Inhibitors

What are the study tips for ACE Inhibitors (for pharmacy exams)

1. Use Mnemonics for understanding and remembering

2. Prepare Flashcard: Create “drug-side effect-use”flashcard

3. Practice Case study scenarios

4. Prepare visual flowcharts for better understanding

How Elite Expertise Can Help you ace these difficult topics and exams. At, Elite expertise, we guide pharmacy professional worldwide to pass tough exams like:

• OPRA (Australia)

• PEBC (Canada)

• PSi (Ireland)

Final take away:

ACE Inhibitors are more than just blood pressure medication. They protect the heart, preserve kidney function, and improve survival after MI or in heart failure. Whether you are preparing for competitive exams or using the knowledge in Clinical practice, understanding the mechanism, side effects, and clinical significance is essential.

💡 Related Read:

Beta Blockers pharmacology : A key topic in the OPRA Exam prepaparation

This blog is intended for educational and informational purposes only. While every effort has been made to ensure accuracy, the information provided does not constitute medical or professional advice. Pharmacy-related content, drug names, uses, and recommendations should always be verified with official guidelines, textbooks, or qualified healthcare professionals. Readers are advised to consult regulatory authorities such as the Pharmacy Board of Australia, PEBC (Canada), or PSI (Ireland) for updated exam and licensing details. Elite Expertise does not provide medical advice but offers academic guidance to pharmacy professionals worldwide.

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About the Author

Krupa Karamchand

Content Writer | Elite Expertise

Krupa Karamchand is a B. Pharm graduate and KAPS-qualified pharmacist with over 7 years of experience in the pharmaceutical field. As an experienced SEO content writer, she combines her in-depth healthcare knowledge with proven digital strategies to create informative, engaging, and search engine–optimized blogs. Krupa is passionate about making complex medical topics easy to understand and accessible to all readers.

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