More Museful Mnemonics Hello everybody. I really do love mnemonics, so here's a new one for all of us studying for PCCN certification. What is the best, but most underprescribed, class of drugs for heart failure?? ACE inhibitors of course. According to Woods et al. in their Cardiac Nursing Textbook, "These agents are the only drugs used in the treatment of chronic HF that have been shown both to improve symptoms and prolong life." To this day, I cannot understand why my grandmother, the typical class III CHFer, has not been taking these drugs; she and others like her should take them like vitamins. Rather, these patients are simply prescribed more and more diuretics, with more and more renal impairment. So any way, if you can remember PACE for ACE inhibitor, then you've got a good start.

For the species of the ACE inhibitor family: PACE

• P-Prinivil/Zestril = lisinopril
  
• A-Accupril = quinapril
  
• C-captopril = Capoten
  
• E-enalapril = Vasotec

For the pharmacology of the class: PACE

• P-preload decrease by venodilation; or potassium levels up (both total body and circulating levels)
  
• A-afterload decrease by blocked angiotensin II
  
• C-circulation of catecholamines down; or complexity and frequency of of ventricular arrhythmias down
  
• E-enuresis (i.e., diuresis) by decreased aldosterone

For the adverse reactions: PACE INH-ibitor

• P-potassium levels high
  
• A-angioedema/aches (musculoskeletal)
  
• C-cough/congenital malformations (esp. in 1st trimester)
  
• E-elevated BUN/Creatinine
• I-insufficiency, renal
• N-neutropenia/nausea & vomiting
• H-hypotension/hepatotoxicity

Ta for now,
Christopher.  ¶ 2:44 PM