Underdosing of angiotensin-converting-enzyme inhibitors digital illustration

Underdosing of angiotensin-converting-enzyme inhibitors Save


ICD-10 code: T46.4X6

Chapter: Injury, poisoning and certain other consequences of external causes

Underdosing of Angiotensin-Converting-Enzyme Inhibitors

Angiotensin-converting-enzyme inhibitors (ACE inhibitors) are a class of medication used to treat high blood pressure, heart failure, and other cardiovascular conditions. They work by blocking the production of a hormone called angiotensin II, which constricts blood vessels and raises blood pressure. However, underdosing of ACE inhibitors is a common problem that can reduce their effectiveness in managing these conditions.

Underdosing occurs when the prescribed dose of ACE inhibitors is too low to achieve the desired therapeutic effect. This can happen due to various reasons, such as poor adherence to medication regimen, inadequate titration of the dose, or inappropriate dosing based on age, body weight, or renal function. Underdosing can lead to uncontrolled blood pressure, increased risk of cardiovascular events, and poor outcomes in heart failure patients.

  1. Adherence to medication regimen: Many patients do not take their medication as prescribed, either by missing doses or discontinuing the medication altogether. This can happen due to forgetfulness, side effects, or lack of understanding of the importance of medication adherence. Healthcare providers should educate patients on the importance of medication adherence and provide strategies to improve adherence, such as pill organizers or reminder apps.
  2. Inadequate titration of the dose: ACE inhibitors are often started at a low dose and gradually increased based on the patient's response and tolerance. However, some healthcare providers may not titrate the dose appropriately, leading to underdosing. Healthcare providers should follow the recommended dose titration guidelines and monitor the patient's response to ensure optimal dosing.
  3. Inappropriate dosing based on age, body weight, or renal function: ACE inhibitors are cleared by the kidneys, and their dose should be adjusted based on the patient's renal function. In addition, the dose may need to be adjusted based on the patient's age and body weight. Healthcare providers should consider these factors when prescribing ACE inhibitors and adjust the dose accordingly.

In conclusion, underdosing of ACE inhibitors is a common problem that can reduce their effectiveness in managing high blood pressure, heart failure, and other cardiovascular conditions. Healthcare providers should educate patients on the importance of medication adherence, follow the recommended dose titration guidelines, and consider the patient's age, body weight, and renal function when prescribing ACE inhibitors. By optimizing dosing, healthcare providers can improve patient outcomes and reduce the risk of cardiovascular events.