Angiotensin-Aldosterone system/ Meds

Question 1

when sodium levels are low and potassium levels are high what happens to aldosterone levels?

Answer 1

they increase to try and raise BP

Question 2

what kind of drug is captopril and enalapril?

Answer 2

ACE

Question 3

ARB drugs end in?

Answer 3

sartan

Question 4

Can ACE inhibitors be given to children?

Answer 4

yes

Question 5

can ACE inhibitors be given to preg patients?

Answer 5

no categoryD

Question 6

can ACE inhibitors be given to old people?

Answer 6

yes

Question 7

how does angiotensin 2 promote renal retention of water?

Answer 7

it constricts blood vessels causing a reduced blood flow which decreases glomerular filtration then it releases aldosterone which promotes Na and water retention which increases BP

Question 8

adverse effects of ACE

Answer 8

angio-edema, cough, hypotension and hyperkalemia

Question 9

how do ACE inhibitors produce their adverse effects? (cough, angio-edema)

Answer 9

they increase levels of bradykinin and reduce levels of angiotensin 2

Question 10

bradykinin

Answer 10

bronchoconstrictor and stimulates release of antidiuretic hormone (which causes a decrease in BP) and is the reason for the cough in ACE

Question 11

Should you give ACE inhibitors with food or not?

Answer 11

yes except for captopril and moexipril

Question 12

how else does ACE hibitors help the heart besides lowering BP?

Answer 12

it decreases cardiac remodeling that forms with angiotensin 2 and aldosterone

Question 13

How are ACE inhibitors excreted and what does this mean?

Answer 13

renal excretion, need to lower dose if patient has renal failure

Question 14

Can ACE inhibitors be given to patients with bronchial asthma?

Answer 14

yes

Question 15

How are ACE inhibitors different than most antihypertensives? (what dont they induce)

Answer 15

they dont induce lethargy, weakness or sexual dysfunction

Question 16

How do ACE inhibitors effect cardiac output?

Answer 16

they increase it

Question 17

How do ACE inhibitors effect cardiac afterload?

Answer 17

they reduce it

Question 18

How do ACE inhibitors slow the development of renal injury with diabetics

Answer 18

they lower the glomerular filtration pressure which can normally be increased and cause injury

Question 19

if patient is on a diuretic, what do you need to do first before adding an ACE?

Answer 19

discontinue diuretic for 2-3 days before taking first dose of ACE

Question 20

ACE vs ARB

Answer 20

ACE=cough, hyperkalemia, block angio 2 PRODUCTION

ARB= no cough, less hyperkalemia, block angio 2 ACTION

Question 21

why dont ARB produce a cough like ACE?

Answer 21

because they block the action of angio 2 not the production so bradykinin is not increased in the lungs

Question 22

How do ACE or ARB effect nephropathy?

Answer 22

they delay the progression NOT prevent it

Question 23

which drugs prevent MI, stroke and death?

Answer 23

ACE and ARB

Question 24

how do ARB or ACE effect diabetic retinopathy?

Answer 24

ARB: slowed it down in type 1 with prior Hx, no effect in type2
ACE: slowed it down in type 1 without prior Hx, no effect in type 2

Question 25

ACE and ARB uses

Answer 25

heart failure, MI, stroke prevention, nephropathies