Cardiac drugs

This dog is suffering from a persistent dry cough due his hypertensive medication. It's probably time he was switched to an ARB instead.

The heart is very useful, and cardiologists attempt to keep it that way. The drugs they use are below:

ACE inhibitors

How they work

They inhibit the action of angiotensin converting enzyme (ACE). This prevents the renin-angiotensin loop from working, thus preventing peripheral constriction of blood vessels, and effectively lower blood pressure.

What are they used for

They are commonly used to treat hypertension and heart failure. They are the first line treatment for white people under the age of 55 with high blood pressure.

Common types and dose

• Ramipril 2.5–5mg OD (max 10mg)
• Perindopril 2-4mg OD

Side effects

They can have a negative effect on renal function, and should never be used on a patient with bilateral renal artery stenosis. They also shouldn't be used with potassium sparing diuretics as this can cause hyperkalaemia.

Their key side effect is a characteristic dry tickling cough, that won't go away. If patients get this, and can't cope with it, you need to take them off the drug, probably best to try them on a angiotensin-II receptor antagonist...

Angiotension II receptor agonists

Also known as ARBs (angiotensin II receptor blockers), they work in a very similar way to ACE inhibitors, but are don't cause the dry cough. In time, they way replace ACE inhibitors as the first line treatment.

Common types and doses

• Losartan 50mg OD, upto 100mg in hypertension.
• Candestartan 32mg OD.

Diuretics

Diuretics are used to control hypertension, by reducing the amount of fluid in the body. They are so sexy that they have their own page. Check it out!