ACE Inhibitors & ARBs

Question 1

ACE stands for

Answer 1

Angiotension converting enzyme

Question 2

ACEI’s

Answer 2

ACE inhibitor, stops ACE from converting Angiotensin I into Angiotensin II then to Aldosterone

Question 3

Aldosterone

Answer 3

Increases Na+ and water retention which raises BP
Increased thirst, SNS activity, vasoconstriction, and myocardial hypertrophy

Question 4

ACE and bradykinin

Answer 4

ACE inhibits bradykinin (vasodilator)

Question 5

ACEI’s and bradykinin

Answer 5

ACEI’s allows bradykinin to vasodilate

Question 6

Angiotensin

Answer 6

vasoconstrictor

Question 7

Bradykinin

Answer 7

vasodilator

Question 8

ACEI’s cause bradykinin to increase or decrease

Answer 8

INCREASE

Question 9

Too much bradykinin in some people cause what

Answer 9

Cough and angioedema

Question 10

ACEI’s suffix

Answer 10

-pril

Question 11

African Americans

Answer 11

ACEI’s and ARB’s are less significant in them
- they have lack of nitric oxide (vasodilator) which is the opposite of angiotensin II

Question 12

ACEI’s are given to patients with

Answer 12

HTN
diabetes, diabetic neuropathy, post-MI, high CAD risk

Question 13

Target dosing

Answer 13

Dosing to a number
- may not be able to get to the target dose if they are already on many drugs

Question 14

ACEI’s side effects

Answer 14

Hypotension & dizziness
Cough & angioedema
renal dysfunction
hyperkalemia

Question 15

Angioedema

Answer 15

Emergency, swelling of mouth and throat
- Should never get another ACE inhibitor if angioedema occurs

Question 16

Renal dysfunction

Answer 16

ACEI’s cause GFR to decrease a bit, isn’t usually harmful, good in diabetes
- SOME people can be a bigger decrease in GFR causing acute renal failure (dehydrated patients, they are on other vasoconstricting drugs, renovascular disease, on diuretics)

Question 17

Hyperkalemia

Answer 17

ACEI’s tend to increase K+ levels, small increase
- SOME people it can be a bigger increase

Question 18

ACEI’s do what to glomerulus

Answer 18

Dilates efferent arteriole
Decreases pressure in glomerulus
Decreases filtration

Question 19

A.T. 2 does what to glomerulus

Answer 19

Constricts efferent arteriole

Question 20

Do not use ACEI’s when

Answer 20

In pregnancy (fetal hypotension)
With bilateral renal artery stenosis

Question 21

ACEI’s interactions

Answer 21

K+ supplements, ACEI’s increase K+ which increases hyperkalemia

NSAIDS (pain relievers), alter BF in glomerulus by decreasing afferent BF so filtration decreases dramatically. High risk to cause renal failure

Cyclosporine (anti rejection drug), can cause kidney dysfunction & hyperkalemia

Question 22

ARB’s stand for

Answer 22

Angiotensin II Receptor Blockers

Question 23

ARB’s do not change what in the blood

Answer 23

The amount of A.T. 2
- A.T. 2 cannot act on its receptor

Question 24

ARB’s difference in side effects from ACEI’s

Answer 24

lack of cough & angioedema

Question 25

What doesn’t build up in the blood with ARB’s?

Answer 25

Bradykinin, since ACE is still able to inhibit bradykinin

Question 26

ARB’s suffix

Answer 26

-sartan