What needs monitoring after starting ACE inhibitors?

• A. Serum creatinine and potassium; blood pressure
• B. Liver enzymes
• C. Hemoglobin
• D. Serum calcium

Answer: (A)

ACE inhibitors affect both kidney function and electrolyte balance, as well as blood pressure. By blocking angiotensin II, they reduce filtration pressure in the kidneys and lower aldosterone levels, which can cause a rise in serum creatinine and an increase in potassium (hyperkalemia). At the same time, these drugs often lower blood pressure, so checking blood pressure after starting therapy helps ensure safe dosing and detects potential hypotension. Therefore, monitoring serum creatinine, potassium, and blood pressure targets the main safety concerns right after initiation or dose changes. Liver enzymes, hemoglobin, and calcium are not routinely required to be monitored specifically for ACE inhibitors, since they are not the primary risks with this class of medication.