HTN3 Flashcards
what ACE-I has a sulfonamide derivative, and should be avoided in pt’s with sulfa allergies?
captopril
what is the half life of captopril
2 hours (BID-TID)
what is the IV formulated ACE-I
enalaprilat
where are the oral prodrug ACE-I’s metabolized to active form?
in liver
what are the adverse effects of ACE-I’s
Hypotension
Acute Kidney Injury
Dry Cough
Angioedema
how do ACE-I’s cause AKI?
cause vasodilation of efferent arteriole, decreasing GFR
where in kidney does Angio II cause constriction
both afferent and efferent (ACEI’s dilate only efferent)
what causes the dry cough with ACE-I’s
increased bradykinin
what irritating endogenous substances are increased by ACE-I’s
increase bradykinan
increase substance P
increase prostaglandins
ARB’s have what type of binding to AT1 receptors
selective binding with high affinity (much higher than Angio II)
what ARB has the highest affinity for AT1 receptors?
which has the lowest?
highest affinity = irbesartan and olmesartan
lowest affinity = losartan
which ARB’s are prodrugs
candesartan and olmesartan
where are pro-drugs hydrolyzed?
in GI tract
what ARB’s are eliminated hepatically (don’t use in pt’s with liver disease)?
Telmisartan and Valsartan
what else are ARB’s used for other than HTN?
which ARB’s are best for which conditions?
DM nephropathy (irbesartan and losartan) stroke prophylaxis (losartan) HF (valsartan)
