CV: Drugs affectin the renin-angiotensin system Flashcards
Mechanism of ACEi
They inhibit the conversion of angiotensin I to angiotensin II.
The indications for ACEi are: (5)
- Heart failure
- Renal protection
- Hypertension
- Diabetic nephropathy
- CV event prophylaxis
ACEi are used in all grades of heart failure, usually combined with what?
A beta-blocker.
A low-dose of what diuretic may be beneficial in severe heart failure and can be used with ACE inhibitor provided what electrolyte level is monitored?
low dose of spironolactone may be beneficial in severe heart failure and can be used with an ACE inhibitor provided serum potassium is monitored carefully.
ACEi is first-line antihypertensive for who
Younger Caucasian patients below 55 and hypertension in patients with type 1 diabetes with nephopathy.
What monitoring accompanies ACEi use?
RFT and U+E should be check before starting/increase dose and monitored during treatment.
What side effects accompany ACEi? (5)
Renal damage (despite role in CKD) High K+ Low Na+ (below 130) Dry cough Angioedema
Use of ACEi and what OTC product can increase the risk of renal damage?
NSAIDs
If the dose of diuretic is greater than __mg furosemide or equivalent, the ACEi should be initiated under close supervision
80
Why are ARBs less likely to cause the persistent dry cough which can complicate ACE inhibitor therapy?
ARBs do not inhibit the breakdown of bradykinin and other kinins.
Which two ARBs are licensed as adjuncts to ACEi under specialist supervision, in the management of heart failure when other treatments are unsuitable?
Candesartan and Valsartan
What is Aliskiren?
Aliskiren is a renin inhibitor that is licensed for the treatment of hypertension.
Aliskiren is a renin inhibitor which is licensed for what?
Hypertension
