Choose the group that is correct.
Select all that apply.

ACE inhibitors are a type of medication used to treat high blood pressure and heart failure. They work by blocking the production of a hormone called angiotensin II, which narrows the blood vessels and increases blood pressure.By preventing this hormone from acting, ACE inhibitors lower blood pressure and reduce the workload on the heart. One of the most common side effects of ACE inhibitors is a dry cough, which occurs in 12–19% of people who take them. The cough is caused by the accumulation of a substance called bradykinin, which is normally broken down by angiotensin-converting enzyme (ACE).When ACE is inhibited, bradykinin levels increase and cause irritation and inflammation in the airways.

Choice A is wrong because decreased white blood cells are not a common side effect of ACE inhibitors.

However, some people may develop a condition called neutropenia, which is a low level of a type of white blood cell called neutrophils.This can increase the risk of infections and may require stopping the medication.

Choice B is wrong because swelling of the face and lips is not a common side effect of ACE inhibitors.

However, some people may develop a rare but serious allergic reaction called angioedema, which is a swelling of the deeper layers of the skin and mucous membranes.

This can affect the face, lips, tongue, throat, or other parts of the body and can cause difficulty breathing or swallowing.Angioedema can be life-threatening and requires immediate medical attention.

Choice D is wrong because renal failure is not a common side effect of ACE inhibitors.

However, some people may experience a decrease in kidney function or an increase in blood levels of creatinine, which is a waste product filtered by the kidneys.

This is because potassium sparing diuretics do not lower potassium levels in the blood, unlike other types of diuretics.Potassium is an essential electrolyte that serves nerve and muscular functions and is regulated by the kidneys.Low potassium levels can cause irregular heartbeats and other problems. Therefore, patients taking potassium sparing diuretics should avoid food sources that are high in potassium, such as bananas, avocados, spinach, and potatoes.

Choice A is wrong because thiazide diuretics, such as hydrochlorothiazide, can cause low potassium levels in the blood.

Patients taking thiazide diuretics may need to take potassium supplements or eat more potassium-rich foods to prevent hypokalemia.

Choice B is wrong because osmotic diuretics, such as mannitol, do not affect potassium levels in the blood.

They work by increasing the amount of water in the urine, but do not alter the electrolyte balance.

Osmotic diuretics are mainly used to treat cerebral edema and glaucoma.

Choice D is wrong because loop diuretics, such as furosemide, can also cause low potassium levels in the blood.

They work by inhibiting the reabsorption of sodium and water in the loop of Henle, a part of the kidney.

Loop diuretics are used to treat edema and heart failure.

Normal ranges for potassium in the blood are 3.5 to 5.0 millimoles per liter (mmol/L).