HTN4 Flashcards
what is the first line option for HTN in CKD?
ACE-I’s
what effect do ACE-I’s have on peripheral vascular resistance?
decrease peripheral vascular resistance and increases vasodialation
what effect does angiotensin II have?
potent vasoconstrictor
what major effect do ACE-I’s have on CHF
decrease risk of death
what are 4 evidence based benefits of ACE-I’s
- decrease morbidity and mortality in CHF
- decrease CKD progression
- decreases CV events in high risk pts
- protect kidneys in diabetic pts
what is the most common adverse effect of ACE-I’s?
dry cough (20%)
what is the most severe adverse effect of ACE-I’s often seen in the ER?
angioedema (swelling of face)
what are some contraindications with ACE-I’s
- pregnancy
- angioedema
- bilateral renal artery stenosis
- unilateral stenosis
what are some adverse effects of ACE-I’s
- angioedema
- dry cough
- acute renal failure
- hyperkalemia
- sexual disfunction
- rash
7 neutropenia
what should be monitored with pt’s on ACE-I’s
- renal function (BUN and SCr)
- K levels
- BP
If a patient has a high potassium level and is on an ACE-I, especially with acute renal failure, what should be done?
withhold ACE-I for a while until K levels normalize
what is ACE-I’s affect on AKI and CKD
ACE-I’s may cause AKI, but protects kidney in CKD.
d/c ACEI’s with AKI until acute symptoms are gone
what artery condition is contraindicated with ACE-I’s
renal artery stenosis (bilateral or unilateral)
what are the only non-prodrug ACEI’s?
lisinopril and captopril
what is the MOAof ARBs?
what are its effects on vasculature?
inhibit angiotensin II type 1 receptor
increase vasodilation and decrease PVR
