Chapter 31 ACEI and ARBS Flashcards
What is the last name for ARBS
“-sartan”
What is the last name for ACEI’s
“-pril”
what is the prototype ARBS
Losartan
What is the prototype ACEI
Lisinopril
what are the 4 steps of the Renin Angiotensin aldosterone system
- Angiotensinogen is produced by the liver
- Angiotensinogen is converted to angiotensin 1 by renin which is secreted by the kidneys
- ACE secreted from the lungs converts Angiotensin 1 to angiotensin 2
- Angiotensin 2 causes vasoconstriction and releases aldosterone and ADH
why can ACEI’s create angioedema
because ACE is also responsible for the breakdown of bradykinin which is a mediator of inflammation
What are three indications for ACEI’s
-Heart failure
-Recent MI
-If patient is in danger of kidney damage from HTN
What are contraindications for ACEI’s and ARBS
-Hyperkalemia (because ACEI messes with excretion of K+)
-Symptomatically hypotensive (will tank the PT)
-Renal failure (since ACEI are excreted by the kidneys)
What are adverse effects of ACEI
-Cough (build up of bradykinin)
-Orthostatic hypotension
-Angioedema
What are considerations for ACEI
-Check lab levels of K+
-Check BP before administration and 30 min to 1 hour after
What are drug interactions for ACEI and ARBS
-K+ supplements (ACEI and ARBS both reduce the excretion of K+ from the kidneys)
-other drugs that lower BP
-NSAIDS because they decrease effectiveness
what are ARBS effect on bradykinin
they do not affect the breakdown of bradykinin so they do not produce a cough like ACEI do
What pregnancy category are ACEI and ARBS
Both are pregnancy category D
what is one downside of ARBS compared to ACEI
ARBS are more expensive than ACEI