Ace inhibitors are those drugs that inhibit an enzyme Angiotensin converting enzyme. Te major function of this enzyme is to convert angiotensin 1 to angiotensin 2. Te converted angiotensin 2 helps increase the blood pressure by several mechanisms. Sme of these are: scretion of aldosterone which acts on the DCT in the kidney to increase the absorption of sodium and water, aso the secretion of ADH which by its name the Anti Diuretic Hormone, dcreases the excretion of water from the kidney leads to an increase in the and increases blood pressure.
B inhibiting the action of ACE, rmipril inhibits formation of angiotensin 2 thus its subsequent actions are also inhibited and blood pressure is maintained (Lippincott, 2005). Rmiprial has an active form known as ramiprilat. Aministered orally, te absorption of ramipril is usually 50-6-% and when administered with food the absorption of this drug decreases but not significanty. Te drug reaches its peak plasma concentration in about half an hour after administration and the rate of decrease in plasma concentration is as quick. Te drug acts of its C domain with the enzyme at its active site thus inhibiting the binding of angiotensin 1 and its conversion to angiotensin 2.
Te drug has a half life of 20 hours and subsequent doses usually lead to a steady plasma concentration rather than a single dose whose effect is not that steady. Amost 90% percent of the excretion of this drug is through feces whereas the remaining 10% is excreted through urine. Te activity i. ihibition of enzyme activity depends on the doses administered (Trevor, 2008). such Jack can be at a huge risk of developing a thrombosis in any of the vital vessels.
Snce he is suffering already from heart failure, te slow progression of blood i. sasis can lead to thrombus formation in the vessels and may lead to the blockade of one of the vital vessels such as coronary or cerebral vessels. Te prescription of warfarin as a prophylactic medicine would help a smooth flow of blood through these channels. Wrfarin acts by inhibiting the formation of prothrombin which is the step in formation of a thrombus and blocking of blood vessels.
Wth no formation of prothrombin, te risk of developing an ischemic disease due to thrombus or even ischemic heart failure such as MI would be decreased (Trevor, ...
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