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RENAL II Exam 3 > ACEIs and ARBs > Flashcards

ACEIs and ARBs Flashcards

1
Q

ACE Inhibitors

A

**Captopril
**Enalapril
Benazepril
Enalaprilat
Fosinopril
Lisinopril
Moexipril
Perindopril
Quinapril
Ramipril
Trandolapril

MOA: reduce ang II (also prevent inactivation of vasodilation by bradykinin)
Decrease peripheral resistance without changing CO, baroreceptor reflexes intact
Dosing based on half life

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2
Q

Captopril

A

ACE Inhibitor
Active metabolite
Short half life

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3
Q

Enalapril

A

ACE Inhibitor
Short half life
IV use is approved

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4
Q

Benazepril

A

ACE Inhibitor

Long half life

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5
Q

Enalaprilat

A

ACE Inhibitor

HTN emergencies

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6
Q

Fosinopril

A

ACE Inhibitor
Renal and hepatic elimination
Long half life

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7
Q

Lisinopril

A

ACE Inhibitor

Long half life

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8
Q

Moexipril

A

ACE Inhibitor

Long half life

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9
Q

Perindopril

A

ACE Inhibitor

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10
Q

Quinapril

A

ACE Inhibitor

Short half life

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11
Q

Ramipril

A

ACE Inhibitor

Long half life

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12
Q

Trandolapril

A

ACE Inhibitor

Renal and hepatic elimination

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13
Q

Angiotensin receptor blockers

A

**Losartan
**Valsartan
Azilsartan
Candesartan
Eprosartan
Irbesartan
Olmesartan
Telmisartan

MOA: selective blocking of angiotensin II AT1 receptors
No effect on bradykinin

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14
Q

Losartan

A

Angiotensin receptor blockers

Metabolized by CYP450

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15
Q

Valsartan

A

Angiotensin receptor blockers

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16
Q

Azilsartan

A

Angiotensin receptor blockers

17
Q

Candesartan

A

Angiotensin receptor blockers

18
Q

Eprosartan

A

Angiotensin receptor blockers

19
Q

Irbesartan

A

Angiotensin receptor blockers

20
Q

Olmesartan

A

Angiotensin receptor blockers

21
Q

Telmisartan

A

Angiotensin receptor blockers

22
Q

Drugs that block renin secretion

A

Clonidine (alpha 2 - brain)

Propranolol (beta 1 - JGM cells)

23
Q

Renin inhibitor

A

Aliskiren
Inhibits entire RAS through renin
Renin levels increase - rapid increase in renin effect with rapid withdrawal
No bradykinin increase

24
Q

RAS

A

Decrease BP, decrease BV, increase B1 Sympathetic -> increase renin -> increase ang I -> ACE converts ang I to ang II -> increase aldosterone

Ang II -> increase vasoconstriction, increase NaCl/H2O reabsorption
Aldosterone -> increase NaCl/H2O reabsorption

25
Q

ACEIs use

A

HTN, nephropathy, HF, left ventricular dysfunction, AMI, prophylaxis of CVD
Can be used in athletes

26
Q

ACEIs adverse effects

A

**Cough (switching ACEIs can reduce this)
**Angioedema
**Hyperkalemia
**ARF
**Contraindicated in pregnancy
Hypotension
Avoid when using K sparing diuretics, NSAIDs, lithium, allopurinol

27
Q

Renal considerations with ACEIs

A

Prevent/delay progression of renal disease
Dilate efferent > afferent arterioles -> reduce back pressure
Improve RBF and Na excretion in CHF

Rapid decrease in GFR may lead to ARF

28
Q

ACEI induced ARF Risk factors

A

Poor MAP
Volume depletion
Renal vascular disease (stenosis, atherosclerosis)
Vasoconstrictor agents

29
Q

Ang II receptors

A

AT1 - major in adults, vasoconstriction
AT2 - minor in adults, vasodilation

Blocker - AT1&raquo_space;> AT2 -> leaving only effects of AT2

30
Q

ARB uses

A

HTN, diabetic nephropathy, HF, AMI, cardio prophylaxis

31
Q

ARB vs ACEIs

A

ARB more effectively inhibits AT1
ARB allows AT2 to remain active
ACEI increase bradykinin
Less cough and edema with ARB

32
Q

ARB adverse effects

A

Similar to ACEIs without cough

No use during pregnancy

RENAL II Exam 3 (12 decks)

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