Angiotensin-Aldosterone system/ Meds Flashcards
when sodium levels are low and potassium levels are high what happens to aldosterone levels?
they increase to try and raise BP
what kind of drug is captopril and enalapril?
ACE
ARB drugs end in?
sartan
Can ACE inhibitors be given to children?
yes
can ACE inhibitors be given to preg patients?
no categoryD
can ACE inhibitors be given to old people?
yes
how does angiotensin 2 promote renal retention of water?
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
adverse effects of ACE
angio-edema, cough, hypotension and hyperkalemia
how do ACE inhibitors produce their adverse effects? (cough, angio-edema)
they increase levels of bradykinin and reduce levels of angiotensin 2
bradykinin
bronchoconstrictor and stimulates release of antidiuretic hormone (which causes a decrease in BP) and is the reason for the cough in ACE
Should you give ACE inhibitors with food or not?
yes except for captopril and moexipril
how else does ACE hibitors help the heart besides lowering BP?
it decreases cardiac remodeling that forms with angiotensin 2 and aldosterone
How are ACE inhibitors excreted and what does this mean?
renal excretion, need to lower dose if patient has renal failure
Can ACE inhibitors be given to patients with bronchial asthma?
yes
How are ACE inhibitors different than most antihypertensives? (what dont they induce)
they dont induce lethargy, weakness or sexual dysfunction
How do ACE inhibitors effect cardiac output?
they increase it
How do ACE inhibitors effect cardiac afterload?
they reduce it
How do ACE inhibitors slow the development of renal injury with diabetics
they lower the glomerular filtration pressure which can normally be increased and cause injury
if patient is on a diuretic, what do you need to do first before adding an ACE?
discontinue diuretic for 2-3 days before taking first dose of ACE
ACE vs ARB
ACE=cough, hyperkalemia, block angio 2 PRODUCTION
ARB= no cough, less hyperkalemia, block angio 2 ACTION
why dont ARB produce a cough like ACE?
because they block the action of angio 2 not the production so bradykinin is not increased in the lungs
How do ACE or ARB effect nephropathy?
they delay the progression NOT prevent it
which drugs prevent MI, stroke and death?
ACE and ARB
how do ARB or ACE effect diabetic retinopathy?
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
ACE and ARB uses
heart failure, MI, stroke prevention, nephropathies
