B / 6 : Drugs Acting On The RAAS

Question 1

ANGII effects (3)

Answer 1

• Remodeling effect
• Constriction of efferent arteriole and arterioles
• Increased aldosterone release

Question 2

Possible levels of modulating RAAS? (3)

Answer 2

• Inhibit renin release
• Prevent conversion of angiotensinogen to ANGI
• Inhibition of ACE and ANGII receptors

Question 3

What are the ACE inhibitors? (4)

Answer 3

Enalapril, Perindopril, Ramipril, Captopril

CREP

Question 4

ACE inhibitors (-pril)
- Effect
- Indication (4)
- SE
- Extra
- ROA

Answer 4

• Reduction of ANGII and aldosterone levels : reduced BP and vasodilation
• For hypertension, CHF, diabetic neuropathy, acute coronary syndrome
• Dry cough, angiodema, skin rash, acute renal failure
• Prodrugs
• Oral

Question 5

What are the ANGII receptor blockers (ARBs)? (4)

Answer 5

• Losartan
• Valsartan
• Irbesartan
• Valsartan + sacubitril

Question 6

Losartan, Valsartan, Irbesartan
- MOA
- Effect
- Indication
- SE
- Extra
- ROA

Answer 6

• ARBs
• Prevents vasoconstriction, aldosterone and ADH release
• For hypertension, CHF, diabetic neuropathy, acute coronary syndrome
• Teratogenic
• Losartan is the shortest acting
• Oral

Question 7

Valsartan + sacubitril
- MOA
- Effect
- Indication
- Contraindication
- SE
- Extra
- ROA

Answer 7

• Sacubitril is a neprilysin inhibitor
• Reduced breakdown of natriuretic peptides : vasodilation and drop in BP
• For systolic HF
• Angiodema risk due to ACEi
• Hyperkalemia
• Combined effect reduces mortality
• Oral

Question 8

What are the K+ sparing diuretics? (2)

Answer 8

• Spironolactone
• Eplerenone

Question 9

Spironolactone, Eplerenone
- MOA
- Effect
- Indication
- SE
- ROA

Answer 9

• Aldosterone inhibitor
• Inhibition of aldosterone dependant Na+ / K+ ATPase
• Hyperaldosteronism, antiandrogenic uses (+HT for E)
• Hyperkalemia, metabolic acidosis
• Oral

Question 10

3 categories of drugs acting on RAAS

Answer 10

• ACE inhibitors
• ANGII receptor blockers
• K+ sparing diuretics