Chapter 47: Drugs acting on the RAAS

Question 1

actions of angiotensin II

Answer 1

• vasoconstriction
• release of aldosterone
• alteration of cardiac and vascular structure

Question 2

actions of aldosterone

Answer 2

• regulation of blood volume and blood pressure
• pathologic cardiovascular effects

Question 3

function of renin

Answer 3

• catalyzes the formation of angiotensin I from angiotensinogen

Question 4

ACE

Answer 4

• catalyzes the conversion of angiotensin I (inactive) to angiotensin II

Question 5

RAAS acts in 2 ways

Answer 5

• constricts renal blood vessels
• acts of kidneys to promote retention of sodium and water and excretion of potassium

Question 6

ACE inhibitors therapeutic uses

Answer 6

• hypertension
• heart failure
• myocardial infraction
• neuropathy

Question 7

ACE inhibitors adverse effects

Answer 7

• first dose hypotension
• fetal injury (teratogenic)
• cough
• hyperkalemia
• renal failure
• angioedema
• neutropenia

Question 8

Angioedema

Answer 8

• potentially liffe-threatening reaction
• patient reports edema of the tongue, lips or eyes.
• patient should never take ACE inhibitors again

Question 9

what is the only ACE inhibitor that is not taken orally

Answer 9

enalaprilat

Question 10

Captopril must be taken on a

Answer 10

empty stomach

Question 11

ACE inhibitors example

Answer 11

the ‘PRILS’
- benazepril, captopril, enalapril, enalaprilat, fosinopril, lisinopril, perindopril, quinapril, ramipril, trandolapril

Question 12

Angiotensin II receptor blockers (ARBs) effects

Answer 12

• cause dilation of arterioles and veins
• reduce excretion of potassium
• decrease release of aldosterone
• increase renal excretion of sodium and water

Question 13

Unlike ACEI’s, ARBs

Answer 13

• do not inhibit kinase II
• do not increase levels of bradykinin

Question 14

ARBs therapuetic uses

Answer 14

• hypertension, heart failure, myocardial infraction
• diabetic neuropathy
• may prevent development of diabetic retinopathy

Question 15

ARB adverse effects

Answer 15

• angioedema
• fetal harm
• renal failure
• lower instance of cough versus ACE

Question 16

Angiotensin II receptor blockers examples

Answer 16

The “Sartans”
- candesartan, Irbesartan, Olmesartan, Losartan [Cozaar], telmisartan, Valsartan

Question 17

Selective aldosterone receptor blocker example

Answer 17

Eplerenone [Inspra]

Question 18

Eplerenone [Inspra] therapeutic uses

Answer 18

• hypertension
• heart failure

Question 19

Eplerenone [Inspra] adverse effects

Answer 19

• hyperkalemia
• diarrhea
• cough
• fatigue
• gynecomastia

Question 20

Eplerenone [Inspra] drug interactions

Answer 20

• inhibitors of CYP3A4
• drugs that raise potassium levels

Question 21

aldosterone antagonists example

Answer 21

Spironolactone [Aldactone]

Question 22

Spironolactone [Aldactone] therapeutic uses

Answer 22

• hypertension
• heart failure

Question 23

Spironolactone [Aldactone] adverse effects

Answer 23

• hyperkalemia
• gynecomastia, menstrual irregularities, impotence
• hirsutism
• deepening of the voice