Medications Acting on the RAAS System Flashcards
ACE Inhibitors (ACEI) end in?
-pril
ACEI MOA
Reduce levels of angiotensin II by blocking conversion of angiotension I and increase levels of bradykinin
Why does bradykinin increase and what does bradykinin do?
It is a potent vasodilator and is present in abundance when ACEI are present due to the decrease in deterioration of the peptide
ACEI Therapeutic Uses
HTN
HF
MI
Diabetes
Nephropathy
Prophylaxis of cardiac patients
Blocking angiotensin I from converting to angiotensin II r/t ACEI does what?
Vasodilation, decrease blood volume, potassium retention, decrease cardiac and vascular remodeling
Blocking Kinase II from converting bradykinin from an active form to an inactive form does what?
Cause vasodilation, increase coughing, and potentially (yet rarely) cause angioedema
ACEI Side Effects
HYPOTENSION (first dose)
Hyperkalemia (blocking excretion)
Cough (bradykinin)
Angioedema (can be attributed to the bradykinin)
Fetal Injury (decrease blood flow to the fetus)
ACEI Drug Interactions
Diuretics
ANY Antihypertensive Agent
Drugs that INCREASE POTASSIUM
Lithium
NSAIDS
ARBs MOA
Blocks access of angiotensin II causing dilation of arterioles and veins, reducing excretion of potassium, aldosterone, increasing renal excretion of water and sodium
DOES NOT INHIBIT KINASE II (NO BRADYKININ) = NO COUGH
ARBs end in?
-sartan
Therapeutic use of ARBs
HTN
HF
Diabetic retinopathy (can prevent too)
Patients that cannot tolerates ACEI
ARBs Side Effects
Angioedema
Renal Failure
Fetal Injury
NO cough r/t NO BRADKININ INCREASE
Direct Renin Inhibitors MOA
Completely block renin release decreasing the cleavage of angiotensinogen to angiotensin I
Direct Renin Blockers end in?
-ren
Direct Renin Inhibitor Side Effects
Angioedema
Cough
GI effects
Hyperkalemia
Fetal Injury and death
Aldosterone Antagonists MOA
selective blockade of aldosterone receptors decreasing effects
So why use ACEI if there are so many side effects?
Decrease orthostatic hypotension
Safely used with bronchial asthma
Does not promote hypokalemia, hyperglycemia, hyperuricemia
Reduce mortality r/t HTN
Generally well tolerated
