In evaluating ACE inhibitors, which scenario represents a contraindication?

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Multiple Choice

In evaluating ACE inhibitors, which scenario represents a contraindication?

The main idea is that ACE inhibitors have several clear contraindications where blocking angiotensin II would harm renal or fetal health or provoke dangerous reactions. In bilateral renal artery stenosis, the kidneys rely on angiotensin II to constrict the efferent arteriole and maintain glomerular filtration. Inhibiting this mechanism lowers glomerular pressure and can cause acute kidney injury or failure. In pregnancy, ACE inhibitors are teratogenic and can damage fetal kidneys, leading to serious fetal complications. A history of angioedema with ACE inhibitors signals a high risk of recurrent, potentially life-threatening swelling if the drug is used again. Together, these scenarios represent absolute reasons to avoid ACE inhibitors. Hypertension without renal disease is a common indication for ACE inhibitors and not a contraindication. Hyperlipidemia isn’t related to ACE inhibitor use. Hypokalemia isn’t an outright contraindication, though ACE inhibitors can affect potassium levels and would require caution or correction of potassium before starting.

The main idea is that ACE inhibitors have several clear contraindications where blocking angiotensin II would harm renal or fetal health or provoke dangerous reactions. In bilateral renal artery stenosis, the kidneys rely on angiotensin II to constrict the efferent arteriole and maintain glomerular filtration. Inhibiting this mechanism lowers glomerular pressure and can cause acute kidney injury or failure. In pregnancy, ACE inhibitors are teratogenic and can damage fetal kidneys, leading to serious fetal complications. A history of angioedema with ACE inhibitors signals a high risk of recurrent, potentially life-threatening swelling if the drug is used again. Together, these scenarios represent absolute reasons to avoid ACE inhibitors.

Hypertension without renal disease is a common indication for ACE inhibitors and not a contraindication. Hyperlipidemia isn’t related to ACE inhibitor use. Hypokalemia isn’t an outright contraindication, though ACE inhibitors can affect potassium levels and would require caution or correction of potassium before starting.

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