Commony Rx Drugs - ACEi (Overview) Flashcards
What are the monitoring requirements of ACEi? (2)
Renal function, Electrolytes = checked before starting an ACE and during tx.
Increased frequency of monitoring in higher risk individuals or those experiencing s/e.
What are the risks associated with using ACEi in pregnancy? (3)
Affects foetal and neonatal BP control
Renal function
Skull defects/oligohydramnios.
What is the risk associated with taking ACEi? (1)
Angioedema
What are the main features of angioedema? (3)
Patients with hx of ACEi induced Angioedema shouldn’t be reintroduced.
Angioedema is due to excessive accumulation of bradykinin.
Individuals with lower activity of bradykinin metabolism are at higher risk of bradykinin accumulation and Angioedema.
Define RAS. (1)
Narrowing of 1 or more arteries that carries blood to your kidneys.
Explain the MOA of ACEI/ARB in the kidneys.
Angiotensin II vasoconstriction efferent arteriole.
Increased glomerular capillary pressure = increased permeability and proteinuria.
ACE/ARB causes vasodilation of efferent arteriole by angiotensin II reduction/antagonism at receptor.
Benefits of ACE/ARB are decreased inraglomerular pressure. Hence reduction in proteinuria.
Continuing ACEi/ARB will lead to acute renal failure as renal function becomes dependent on sustained efferent arteriole constriction by angiotensin II.
What is Angioedema? (1)
Swelling in the deep layers of skin and other tissues.
What are the s/s of Angioedema? (7)
Itchy,raised rashes (hives)
Eye swelling
Lip Swelling
Ab pain
SOB
Dizziness
Fainting
Where in the body are the common areas Angioedema can occur? (7)
Eyes
Lips
Mouth
Tongue
Genitals
Hands
Feet
What factors can affect afferent blood flow? (4)
Afferent vasoconstriction (NSAIDs)
Decreased intravascular volume (dehydration, diuretic overuse, CHF, vomiting, diarrhoea)
Sepsis
RAS
