What medication management decisions must be made


Problem

Joe is a 42-year-old woodwind musician with the symphony orchestra, is started on a generic angiotensin-converting enzyme (ACE) inhibitor for his newly diagnosed hypertension. He returns to the clinic in a month and demonstrates that his original blood pressure of 150/90 mm Hg has improved to 130/80 mm Hg. He denies chest pain, orthostasis, or peripheral edema. He believes that the medication is working well. As he is getting ready to leave, he mentions that he appears to be "catching a cold". He has a persistent, but nonproductive cough. It is starting to affect his breath control required to play his instruments. He believes it is a cold because his upper lip feels thick, full, and a bit tingly as if he is getting a cold sore.

i. What is occurring?
ii. What is the source of his cough?
iii. Why are his lips swollen and tingly?
iv. What medication management decisions must be made?
v. Complete the following table regarding categories of antihypertensive agents.

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