Which drug class should not be used when a patient is taking nitrates?

Intermittent claudication is a condition where leg pain is produced upon increased activity and ischemia to tissues, but then the pain is reduced with rest.This is because the lack of oxygen to the muscles causes pain, and resting allows the blood flow to resume.

Choice B, sporadic ischemia, is wrong because it is not a specific condition, but a general term for reduced blood supply to a tissue or organ.

Choice C, angina, is wrong because it is a chest pain caused by reduced blood flow to the heart, not the legs.

Choice D, paresthesia, is wrong because it is a sensation of tingling, numbness, or prickling in the skin, not pain.

It can be caused by various conditions, such as nerve damage, diabetes, or Raynaud’s disease.

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.