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Therapeutics Exam 5 > ACE/ARB/DIURETICS > Flashcards

ACE/ARB/DIURETICS Flashcards

1
Q

Renin Inhibitor: Aliskiren

A

Direct inhibitor of renin and decreases formation of angiotensin 1 from angiotensinogen

HTN

NO USE IN PREGNANCY OR LACTATION

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2
Q

Lisinopril

A

most commonly used
T1/2 life: 12 hours
NOT A PRODRUG

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3
Q

Enalapril

A

prodrug hydrolyzed to
active enalaprilat

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4
Q

Captopril

A

Thiol-containing
NOT A PRODRUG
T1/2: 3 hrs

Indication: supine hypertension, orthostaTIc hypotension

side effects: rash, neutropenia, agranulocytosis

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5
Q

Fosinopril

A

phosphonate-containing
PRODRUG

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6
Q

Indications

A

first line monotherapy for HTN, heart failure

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7
Q

Advantages

A

Beneficial in HF, CKD, DM, ischemic heart disease

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8
Q

Disadvantages

A

not useful in African American

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9
Q

Side effects

A

cough, angioedema

hyperkalemia due to increase in bradykinin

DO NOT USE IN PREGNANCY OR BREASTFEEDING

avoid NSAIDS as that may reduce effectiveness

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10
Q

ARB’S

A

Block angiotensin 2 receptor with much higher affinity for AT1 vs AT2

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11
Q

Potency of products

A

candesartan=olmesartan>irbesartan=eprosartan>telmisartan=valsartan=losartan

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12
Q

ARB structure

A

imidazole ring, phenyl ring, and either tetrazole or carboxylic acid

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13
Q

Indications

A

first line monotherapy in hypertension (cannot tolerate ACE-I)

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14
Q

Advantages

A

not associated with dry cough

beneficial in CKD, DM, and ischemic heart disease

beneficial in reducing uric acid and be used especially with people with gout

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15
Q

Disadvantages

A

not useful in AA

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16
Q

Side effects

A

hypotension, hyperkalemia, angioedema, reduction in GFR

DO NOT USE IN PREGNANCY OR LACTATION

17
Q

Aldosterone receptor antagonist

A

block reabsorption of sodium in the bloodstream reducing BP

Chronic HF, HTN, aldosteronism

not monotherapy for HTN but can help reduce hypokalemia

SE: hyperkalemia, gynostemia, impotence

DO NOT USE IN PREGNANCY OR LACTATION

18
Q

Thiazides (Chlorthalidone)

A

blocking the Na Cl cotransporter in DCT

Initially reduces blood volume and CO by diuretic effect

long term lowers peripheral resistance due to decreased muscle sensitivity

first line monotherapy for HTN

Effective in AA

Not drug of choice in diabetes, hyperlipidemia, gout

SE: hypokalemia, hyperuricemia, metabolic acidosis, hypercalcemia, hyperlipidemia, hyperglycemia

Therapeutics Exam 5 (11 decks)

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