QuestionSBA
QuestionChoice
It is recommended that renal function be checked prior to and monitored during anti-hypertensive treatment with ACE inhibitors. The treatment may be modified or stopped if there is any evidence of new renal impairment
34420
a
Renal function tests
QuestionChoice
It is not necessary to perform routine monitoring with spirometry during anti-hypertensive treatment with ACE inhibitors
34423
d
Spirometry
QuestionChoice
It is not necessary to perform routine monitoring with stress echocardiography during anti-hypertensive treatment with ACE inhibitors
34422
c
Stress echocardiogram
QuestionChoice
It is not necessary to monitor the heart rate during anti-hypertensive treatment with ACE inhibitors
34421
b
Heart rate
QuestionChoice
Although peripheral oedema is a documented side effect with ACE inhibitors, it is generally not necessary to monitor weight during treatment
34424
e
Weight
Concept
Chapter
#### Monitoring

The BNF advises to monitor lung function (in patients with a history of obstructive airway disease).

#### Overdoses

Overdosages with beta-blockers may cause cardiac effects such as bradycardia, hypotension, syncope, conduction abnormalities, and heart failure. Bradycardia is the most common arrhythmia, but some beta-blockers may induce ventricular tachyarrhythmias secondary to prolongation of QT interval (e.g. sotalol) or QRS duration (e.g. propranolol).
Non-cardiovascular effects include central nervous system effects (including drowsiness, confusion, convulsions, hallucinations, and in severe cases coma), respiratory depression, and bronchospasm.

Management
 - Airway protection 
 - Activated charcoal within 1 hour
 - IV Fluids
 
IV glucagon is the first-line management.
 
For symptomatic bradycardia, IV atropine may be used.

2618
2827
ACE inhibitor side effects
Topic
92
General Practice
6895
Case Presentation: A 52 year old man attends his GP to receive the results of an ambulatory blood pressure monitoring study. **PMH** stable angina pectoris. **DH** bisoprolol fumarate 10mg PO OD. NKDA


**Investigations**

Clinic BP: 151/95mmHg

Ambulatory daytime average: 142/84mmHg

His GP decides to prescribe ramipril 2.5mg PO OD and schedules a follow-up appointment in 2 weeks.

Question: Select the most appropriate option to monitor for adverse effects of this treatment.
a