ACE inhibitors

Question 1

Captopril

Answer 1

Capoten

Question 2

Enalapril

Answer 2

Vasotec

Question 3

Lisinopril

Answer 3

Zestril/Prinivil

t1/2 = 13 hours

Question 4

Benazepril

Answer 4

Lotensin

t1/2 = 10 hours

Question 5

Fosinopril

Answer 5

Monopril

Question 6

Moexipril

Answer 6

Univase

Question 7

Quinapril

Answer 7

Accupril

Question 8

Ramipril

Answer 8

Altace

Question 9

Trandolapril

Answer 9

Mavik

Question 10

Perindopril

Answer 10

Aceon

Question 11

MOA of ACE inhibitors

Answer 11

1. decreased formation of angiotensin-2
2. increased levels of circulating bradykinin
3. increased formation of angiotensin 1-7 (indirect)
4. Chronic Use: increase in renin levels and activity due to negative feedback of Angiotensin-2 depression

Question 12

Location of AT1 receptor: Vasculature

What is the effect?

Answer 12

1. Vasoconstriction

2. Smooth Muscle hypertrophy

Question 13

Location of AT1 receptor: Adrenal Cortex

What is the effect?

Answer 13

Synthesis and secretion of aldosterone –> increases Na/H2O retention

Question 14

Location of AT1 receptor: Adrenal Medulla

What is the effect?

Answer 14

release of epinephrine

Question 15

Location of AT1 receptor: Kidney

What is the effect?

Answer 15

1. Major efferent arteriole vasoconstriction –> increased GFR
2. Inhibition of renin release
3. Increased Na+ reabsorption in proximal tubule

Question 16

Location of AT1 receptor: Heart

What is the effect?

Answer 16

Myocardial hypertrophy and collegen synthesis

Question 17

Location of AT1 receptor: Brain

What is the effect?

Answer 17

1. Release of vasopression (ADH)
2. Stimulation of thirst and salt appetite
3. Increased central sympathetic outflow

Question 18

Clinical Pearls

Answer 18

1. Decrease/Stabilize albuminuria
2. Chronic renal insufficiency is NOT a contraindication as long as you start low and go slow
3. Monitor renal function (SrCr, K+)
4. Limit salt intake