ACEIs and ARBs

Question 1

ACEIs

Answer 1

captopril
enalapril
enalaprilat
-pril

Question 2

ARBs

Answer 2

Losartan
Valsartan
-tan

Question 3

drugs that block renin secretion

Answer 3

clonidine

propranolol

Question 4

renin inhibitors

Answer 4

aliskriren

Question 5

AT1R

Answer 5

Gq -> PLC -> IP3 &DAG -> SM contraction

Question 6

AT2R

Answer 6

bradykinin and NO production

Question 7

ACEIs

Answer 7

lowers BP by decreasing TPR

CO and HR not changed, making these agents an excellent choice in athletes

Question 8

ACEIs indications

Answer 8

HTN, nephropathy, HF, left ventricular dysfunction, AMI, prophylaxis of CVD events

Question 9

ACEI adverse effects

Answer 9

hypotension
acute renal failure
hyperkalemia
dry cough (common reason for termination)
angioedema

Question 10

ACEI and pregnancy

Answer 10

Contraindicated
First semester- teratogen
Second and third trimester- fetal hypotension, anuria, renal failure, death

Question 11

ACEI Drug interactions

Answer 11

should avoid K supplements and K sparing diuretics and nonsteroidal anti-inflammaotry drugs

Question 12

ARB MOA

Answer 12

block AT1R

no effect on bradykinin metabolism therefore more selective antagonits of angiotensin effects than ACE inhibitors

Question 13

ARB indications

Answer 13

used to treat HTN, diabetic nephropathy, HF, or left ventricular dysfunction after AMI, prophylaxis of CV events

Question 14

Differences btwn ARBs and ACEIs

Answer 14

ARBs reduce activation of AT1R more effectively then ACEIs
ARBs permit activation of AT2Rs
ACEIs increase the levels of a number of ACE substrates including bradykinin

Question 15

ARB adverse effects

Answer 15

similar to ACEIs, but cough and angioedema less common

Question 16

ARB contraindications

Answer 16

pregnancy
nondiabetic renal disease
K supplements and K sparring diuretics

Question 17

clonidine MOA

Answer 17

agonist of alpha 2 receptors in brain-> inhibition of sympathetic vasomotor centers -> centrally mediated reduction in renal sympathetic n activity -> reduction of renin

Question 18

propranolol MOA

Answer 18

non-specific antagonists of beta R
act on JG cells by blocking beta1R stimulated release of renin and thereby decrease bp
also decreases BP by decreasing CO and decreasing sympathetic outflow from the CNS

Question 19

aliskiren

Answer 19

PO for HTN
dose-dependent reduction in plasma renin activity
does not cause a rise in plasma renin activity in contrast to ACEIs, ARBs, and diuretics
decreased BP
contraindicated in pregnancy and renal insufficiency

Question 20

PRC

Answer 20

increased by: direct renin inhibitors, ACEIs, ARBs, diuretics
no change w/CCBs
decreased w/beta blockers

Question 21

PRA

Answer 21

increased by ACEIs, ARBs, and diuretics
no change w/CCBs
decreased w/direct renin inhibitors and beta blockers

Question 22

ANG I

Answer 22

increased w/ACEIs, ARBs, diuretics,
no change w/CCBS
decreased w/ direct renin inhibitors, and beta blockers

Question 23

ANG II

Answer 23

increased w/ARBs and diuretics
non change w/CCBs
decreased w/direct renin inhibitors, ACEIs, and beta blockers

Question 24

ACE

Answer 24

no change w/direct renin inhibitors and ARBs

decreased w/ACEIs

Question 25

Bradykinin

Answer 25

no change w/direct renin inhibitors and ARBs

increased w/ACEIs

Question 26

AT1R

Answer 26

inhibited by ARBs

Question 27

AT2R

Answer 27

stimulated by ARBs