A prescriber orders ramipril [Altace] for an obese patient with type 2 diabetes mellitus who has developed hypertension. The nurse provides teaching before dismissing the patient home. Which statement by the patient indicates understanding of the teaching?
a.
"I am less likely to develop diabetic nephropathy when taking this medication."
b.
"I should check my blood sugar more often, because hyperglycemia is a side effect of this drug."
c.
"Taking this medication helps reduce my risk of stroke and heart attack."
d.
"This medication will probably prevent the development of diabetic retinopathy."

In type II diabetes, the body is unable to adapt to the insulin it produces; this condition has several comorbidities, such as cardiovascular events. A pro-drug, ramipril belongs to the angiotensin-converting enzyme (ACE) family- it is metabolized in the kidney and more significantly, the liver. This drug is a molecule that acts as an enzyme inhibitor for ACE; it converts angiotensin I (ATI) to angiotensin II (ATII) which in turn allows for blood pressure regulation. Additionally it maybe used in the management of other conditions such as:

Nephropathy
Heart failure
Asthma

It may also reduce the risk of several conditions in persons at risk for cardiovascular events...

Fatality
Heart attack
Stroke

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