Angiotensin inhibitors (general + ACE inhibitors)

Question 1

Angiotensin inhibitors - 3 groups

Answer 1

Angiotensin converting enzyme (ACE) inhibitors.
Angiotensin receptor blockers (ARBs)
Direct renin inhibitor (Aliskiren)

Question 2

ACE inhibitors - cardiovascular effects

Answer 2

PVR: Decrease
Plasma renin activity: (compensatory) increase
Left ventricular hypertrophy: Decrease
Blood pressure: decreases both arterial and venous.

Question 3

ACE inhibitors - effects on potassium

Answer 3

Serum potassium: Increase

Question 4

ACE inhibitors - adverse effects

Answer 4

Acute renal failure (in bilateral renal artery stenosis), angioedema, dry cough, hyperkalemia, loss of taste, neutropenia, rash. Fetal and neonatal injury and death.

Question 5

ACE inhibitors - interactions

Answer 5

Increase lithium.
Potassium sparing diuretics and K supplements - increased hyperkalemic effects.
NSAIDs: decreased hypotensive effect

Question 6

Shorter acting ACE inhibitor

Answer 6

Captopril (6-12 h)

Question 7

Angiotensin inhibitors whose absorption is inhibited by food

Answer 7

Captopril
Quinapril
Losartan
Valsartan
Aliskiren (high fat meal)

Question 8

Angiotensin inhibitors that are preferred for initial treatment of HT - and advantages

Answer 8

ACE inhibitors and ARBs. These groups reduce risk of stroke. Useful in diabetes or heart failure.

Question 9

ACE inhibitors - MOA

Answer 9

Bind to the zinc atom at the active site of ACE. Hypotensive effect by blocking angiotensin II formation, and by blocking breakdown of bradykinin. Increased renal prostaglandin synthesis

Question 10

ACE inhibitors - administration

Answer 10

Oral

Question 11

How can the compensatory increase in renin secretion caused by ACE inhibitors be prevented?

Answer 11

By adding aliskiren.

Question 12

ACE inhibitors - contraindications

Answer 12

Pregnancy

Question 13

ACE inhibitors - indications

Answer 13

Mild to severe HT.
DM with kidney involvement (ACE inhibitors are renoprotective).

Question 14

ACE inhibitors are especially good for pts with..

Answer 14

Heart failure, MI, chronic kidney disease, DM.

Question 15

ACE inhibitors - are protective of which organs?

Answer 15

Renoprotective.
Cerebroprotective

Question 16

ACE inhibitors - 2 drugs + 1 group

Answer 16

Captopril (sulfhydryl compound).
Fosinopril (phosphoryl agent).
Carboxyl derivatives

Question 17

Carboxyl derivatives (ACE inhibitors) - 5 drugs

Answer 17

Benazepril
Enalapril
Lisinopril
Quinapril
Ramipril

Question 18

ACE inhibitor that can be given IV

Answer 18

Enalaprilat - active metabolite of enalapril

Question 19

Treatment of Primary (Essential) Hypertension by drug type

Answer 19

thiazide diuretics

ACE inhibitors

angiotensin II receptor blockers (ARBs)

dihydropyridine Ca2+ channel blockers

Question 20

why are ACE I inhibitors used for HTN with diabetes mellitus?

Answer 20

they are protective against diabetic neuropathy

Question 21

name the Calcium channel blockers

Answer 21

amlodipine

clevidipine

nicardipine

nifedipine

nimodipine

verapamil

diltiazem