CARDIOVASCULAR CASE STUDY 3 Flashcards
What is the mechanism of action of enalapril?
An ACE inhibitor. Inhibits conversion of angiotensin I to angiotensin II by blocking activity of angiotensin converting enzyme (ACE). This consequently inhibits the angiotensin II-stimulated release of aldosterone, as well as impairing the inactivation of bradykinin.
What is the likely cause of the cough?
A secondary effect caused by increased bradykinin levels as it is not being inactivated.
What is the mechanism of action of losartan?
An antagonist of the angiotensin-2 (AT-2) receptor, which mediates the pressor effect of angiotensin II, increasing plasma renin activity due to lack of angiotensin II feedback. Losartan blocks the downstream effects of renin and angiotensin II, ultimately decreasing blood pressure.
Why are angiotensin II receptor antagonists often preferred to ACE inhibitors?
Both are considered effective treatments, but angiotensin II receptor blockers are typically front-line treatment due to their better safety profile and fewer side effects.
What are some adverse effects and drug interactions the patient should be mindful of with losartan?
Contraindicated in pregnancy (probably not relevant to this patient).
Significant interactions with some antibiotics and antifungals, as well as barbiturates.
Common adverse effects may include back pain, dizziness and increased occurrence of upper respiratory tract infections.
