ACEsARBs Flashcards
Angiotensinogen is converted to Angiotensin I by
Renin
True or False:
Angiotensin-converting enzyme (ACE) is the only pathway to convert angiotensin I to angiotensin II
False
Chymase and Tissue ACE also produce angiotensin II
What effect does aldosterone have on Na/H20 reabsorption?
Increases
this increases preload and therefore BP
What effect does aldosterone have on the heart and blood vessels?
Causes detrimental remodeling
Due to effects in the kidneys, ACEi/ARBs may lead to ____ serum K+
Increased
True or False:
Angiotensin Receptor Blockers (ARBs) inactivate angiotensin II type 1 AND type 2 receptors
False
ACEi/ARBs cause a(n) ____ in preload
Decrease
prevents Na/H20 reabsorption
ACEi/ARBs cause a(n) ________ in afterload
Decrease
prevention of vasoconstriction by angiotensin II
What is the common suffix shared by the ACEi’s
name several ACEi’s
“pril”
e.g. enalapril, lisinopril, captopril
What is the common ending or suffix shared by the ARB medications?
name several ARB’s
“sartan”
e.g. losartan, valsartan
ARB’s are frequently combined with what other medication class?
Thiazide Diuretics
What is the reason that ACEi cause a dry/non-productive cough?
Prevents the metabolism of bradykinin, leading to an increase in NO (causes irritation to lungs)
What is the most dangerous ADR of ACEi/ARBs
Angioedema
I’ll take hyperkalemia too…
Why can angiotensin II levels rise, even if a patient is compliant with ACEi therapy?
The body has additional routes of producing angiotensin II - may upregulate
This is why the ARB medications were developed
As monotherapy, ACEi/ARBs may be ________ effective in the african american population
Bonus points if you can explain why
less
They generally tend to have less renin release
True or false:
ACEi/ARBs confer a renal protective effect in diabetics
True
less pressure in glomerulus, prevents remodeling/damage
NSAIDs ________ effectiveness of ACEi
bonus for why
decrease
inhibit prostaglandin, which is needed to maintain afferent flow
What are the three absolute contraindications to ACEi/ARBs?
Bilateral renal artery stenosis
Angioedema
Pregnancy
What is the mechanism of action of ACEi?
prevents the conversion of angiotensin I to angiotensin II
angiotensin II is responsible for vasoconstriction, aldosertone release
Describe pseudotolerance in relation to antihypertensive medications
When a medication decreases CO/BP, kidneys release renin to compensate
(ACEi and ARBs do not cause this psuedotolerance)
What ACE-I is typically used in acute care for it’s “titratability”
Captopril (Half life around six hours)
What ACE-I are NOT prodrugs?
Lisinopril
Captopril
ACE-I ___________ insulin sensitivity.
Increase
ACE-I/ARBS are first choice options for…
HTN with DMII
ACE-I/ARBs are effective monotherapy for African-Americans.
False
What lab value should be monitored before after a few months after starting ACEis
WBC - can cause neutropenia
True or False : ACEis increase myocardial oxygen supply and decrease myocardial oxygen demand
TRUE
True or False: ACEis can reduce remodeling effects of Aldoserone
TRUE
reduced secretion of aldosterone decreases the retention of sodium and water,
