Join Dr. Mobeen Syed for a detailed exploration of ACE inhibitors (ACEIs), one of the most widely used classes of cardiovascular drugs. This lecture explains why there are so many ACEIs, how they differ in dosage, half-life, absorption, and clearance, and how these differences shape clinical decision-making. From short-acting captopril for hypertensive emergencies to long-acting agents like ramipril and perindopril proven in outcome trials, you will learn how to select the right drug for the right patient. Special attention is given to considerations in renal and hepatic impairment, patient compliance, and IV versus oral use. By the end of this session, you’ll be able to confidently differentiate ACE inhibitors not just by name, but by their real-world pharmacology and clinical pearls.

Objectives:
By the end of this session, learners will be able to:

Explain the rationale for the development of multiple ACE inhibitors and describe their key pharmacological differences (activation, duration, clearance).

Differentiate ACE inhibitors based on duration of action (short, intermediate, long), route of administration (oral vs IV), and prodrug vs active drug status.

Identify clinical considerations in selecting an ACE inhibitor, including:

Hypertensive emergency use (e.g., captopril, enalaprilat IV).

Chronic therapy and patient compliance (once-daily vs multiple-daily dosing).

Impact of renal or hepatic impairment on drug choice (e.g., fosinopril in CKD).

Apply clinical pearls from major outcome studies (e.g., ramipril in HOPE, perindopril in EUROPA) to therapeutic decision-making.

Recognize common adverse effects shared by the ACEI class (cough, angioedema, hyperkalemia) and understand subtle differences in risk.