What is a common adverse effect of ACE inhibitors that requires monitoring?

• A. Cough and hyperkalemia; monitor renal function
• B. Hypokalemia and dehydration
• C. Bradycardia
• D. Liver injury

Answer: (A)

ACE inhibitors frequently cause a dry cough and hyperkalemia. The cough comes from increased bradykinin levels in the airways, and hyperkalemia occurs because blocking the enzyme reduces aldosterone-driven potassium excretion. Because these drugs can also affect kidney function, it's important to monitor renal function and potassium after starting or adjusting therapy, especially in patients with CKD or renal artery stenosis. The other adverse effects listed—hypokalemia and dehydration, bradycardia, and liver injury—are not the common or most concerning effects with ACE inhibitors, making cough with hyperkalemia and renal monitoring the best match.