When monitoring a patient on ACE inhibitors, which labs and measurements should be checked?

• A. BUN/creatinine, potassium, and blood pressure
• B. CBC, platelets, and glucose
• C. Liver enzymes and bilirubin
• D. Lipid panel and urinalysis

Answer: (A)

Monitoring an ACE inhibitor focuses on how it affects kidney function, potassium, and blood pressure. These drugs can reduce kidney perfusion in some patients, which may raise BUN and creatinine levels, signaling potential kidney stress or early injury. They also decrease aldosterone, reducing potassium excretion and raising the risk of hyperkalemia. Additionally, their vasodilating effect can lead to hypotension, so frequent blood pressure checks are important to ensure safe and effective therapy. Therefore, the best set to monitor is BUN/creatinine, potassium, and blood pressure, with baseline values and follow-up testing after starting or changing the dose, especially in those with CKD, dehydration, or interacting medications. CBC, liver enzymes, bilirubin, lipid panel, and urinalysis aren’t the primary monitoring targets for ACE inhibitors unless there’s another unrelated concern.