The primary care NP is considering prescribing captopril (Capoten) for a patient. The NP learns that the patient has decreased renal function and has renal artery stenosis in the right kidney. The NP should:
a. initiate ACE inhibitor therapy at a low dose.
b. consider a different drug class to treat this patient's symptoms.
c. give the captopril with a thiazide diuretic to improve renal function.
d. order lisinopril (Zestril) instead of captopril to avoid increased nephropathy.
A
Patients with impaired renal function should use low-dose ACE inhibitors. It is not necessary to avoid ACE inhibitors with unilateral renal stenosis.
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