A patient who is taking an ACE inhibitor sees the primary care NP for a follow-up visit. The patient reports having a persistent cough. The NP should:
a. consider changing the medication to an ARB.
b. order a bronchodilator to counter the bronchospasm caused by this drug.
c. ask whether the patient has had any associated facial swelling with this cough.
d. reassure the patient that tolerance to this adverse effect will develop over time.
A
A persistent cough may occur with ACE inhibitors and may warrant discontinuation of the drug. An ARB would be the next drug of choice because it does not have this side effect. The cough is not related to bronchospasm. Angioedema is not related to ACE inhibitor–induced cough. Patients do not develop tolerance to this side effect.
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