ACEI and ARBs Flashcards
Neprilysin Inhibitor: Drugs
Sacubitril and Valsartan
Neprilysin Inhibitor MOA
Stops degradation of endogenous vasoactive peptides
Neprilysin Inhibitor Effects
Vasodilation
Natriuresis
Diuresis
Inhibited pathological growth and fibrosis
Neprilysin Inhibitor ADRs
Hyperkalemia
cough/angioedema
ARF/AKI
Hypotension
Valsartan (entreso)
Reduce risk of CV death and hospitalization
For HF patients with CHF and Reduced EF
ARNI: Angiotensin Receptor Neprilysin Inhibitor
works better than Enalapril
Angiotensin Converting Enzyme Inhibitors (ACEI)
Lisinopril Enalapril Quinapril Captopril Ramipril Benazepril Fosinopril Moexipril Perinopril Trandolapril
ACEI MOA
inhibits angiotensin converting enzyme, which prevents the formation of angiotensin II, which stops the increase of BP
ACEI Therapeutic Use
Hypertension Post MI Heart Failure with reduced Ejection Fraction Chronic Kidney Disease Decreases Proteinuria (Renal protection)
ACEI ADRs
Dry cough and Angioedema from bradykinin buildup Hyper K+ Acute Renal Failure Teratogenic Reduced efficacy in African Americans AFI/AKI in starting medication
Direct Renin Inhibitor
Aliskiren
Aliskiren MOA
Competitive enzyme inhibitor, prevents generation of angiotensin I (stops renin)
Aliskiren Therapeutic Use
Comparable BP reduction to ACEI/ARB in HTN
Aliskiren ADR
Hypotension Hyper K+ ARF/AKI Rare angioedema teratogenic
Aliskiren Contraindications
Don’t combine with ACEI/ARB (especially in Diabetes II) , it will worsen above symptoms and increase risk of angioedema, stroke, and MI
Angiotensin Receptor Blockers (ARBs) Drugs
Losartan Valsartan Olmesartan Irbesartan Candesartan Telmisartan Eprosartan Azilsartan