Lisinopril

Class ACE-inhibitor
Chemistry

L-proline derivative with dicarboxylate (-COOH) group

Routes of administration

Oral

Absorption

25% oral bioavailability

Solubility

pKa 2.5

Distribution

124L

Metabolism

No hepatic metabolism

Elimination

100% of the dose is excreted unchanged by the kidneys

Time course of action

Effects are maximal ~ 1 hour following oral administration

Target receptor

ACE enzyme

Mechanism of action

By interfering with a zinc moiety on the ACE enzyme, this drug nterrupts the conversion of Angiotensin-I into Angiotensin-II, thereby interrupting the effects of renin-angiotensin-aldosterone system activation, which are mainly mediated by Angiotensin II via the AT1 receptor.

Clinical effects

Vasodilation (without reflex tachycardia), increased natriuresis, increased sensitivity to diuretics, decreased glomerular filtration. Positive effects of vascular and myocardial remodelling in CCF. Also, dry irritating cough and a chance of random angioedema.

Literature reference

Regulski et al (2015)

CICM details of understanding Not specifically listed in the CICM syllabus
Mentioned around Deranged Physiology
Related SAQs