Lisinopril
An ACE inhibitor that lowers blood pressure by blocking the conversion of angiotensin I to angiotensin II.
The exam loves the “-pril” suffix as the tell, then makes you pick the assessment that matters. The highest-yield trap is potassium direction: lisinopril raises K⁺, the mirror image of furosemide, which lowers it — so when the two run together their effects partly offset, and a “concerning lab” usually means K⁺ above 5.0–5.5 mEq/L. Teach patients to avoid potassium-sparing diuretics, salt substitutes (potassium chloride), and routine potassium supplements. When the dry, hacking cough becomes intolerable, the classic move is switching to an ARB (“-sartan”), which spares bradykinin.
The most-tested contraindications are pregnancy (stop as soon as pregnancy is detected; gravest fetal harm is 2nd–3rd trimester) and prior angioedema — facial, lip, or tongue swelling is an airway emergency and an absolute stop. Don’t confuse the pre-dose checks: metoprolol hinges on the apical pulse (hold below 60), while lisinopril hinges on blood pressure. Memory hook: ACE = “A Cough and Elevated potassium.”
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