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Intro to Pharmacology > Pharm Exam III > Flashcards

Pharm Exam III Flashcards

1
Q

Released by the kidneys in response to decreased perfusion:

A

renin

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2
Q

Released by the liver and converted to angiotensin I by renin:

A

angiotensinogen

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3
Q

Activity unknown; converted to angiotensin II by ACE:

A

Angiotensin I

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4
Q

Causes vasostriction, salt retention, vascular growth:

A

Angiotensin II

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5
Q

Stimulates the release of aldosterone:

A

Angiotensin II

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6
Q

Angiotensin II stimulates the release of:

A

Aldosterone

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7
Q

Decreased renal perfusion pressure leads to: (3)

A
  1. INCREASED renin release
  2. INCREASED renal sympathetic nerve activity
  3. DECREASED glomerular filtration
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8
Q

What three scenarios lead to INCREASED renin release?

A
  1. DECREASED renal perfusion pressure
  2. DECREASED glomerular filtration
  3. INCREASED renal sympathetic nerve activity
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9
Q

Angiotensinogen acts on _____

A

Angiotensin I

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10
Q

Angiotensin I is acted on by _____ to produce angiotensin II

A

ACE

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11
Q

What do ACE inhibitors decrease? What does this lead to?

A

ACE; no angiotensin II production

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12
Q

Angiotensin II acts on _____ receptors

A

AT1

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13
Q

What are the receptor antagonist for AT1 receptors?

A

Angiotensin II AT1 subtype receptor antagonist

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14
Q

What are the three effects of angiotensin II acting on AT1 receptors?

A

1) Vascular growth
2) Vasoconstriction
3) Salt retention

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15
Q

Describe the vascular growth caused by angiotensin II:

A
  1. Hyperplasia
  2. Hypertrophy
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16
Q

Describe the vasoconstriction caused by angiotensin II:

A
  1. Direct
  2. Via increased noradrenaline released from sympathetic nerves
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17
Q

Describe the salt retention caused by angiotensin II:

A
  1. aldosterone secretion
  2. tubular Na+ resportion
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18
Q

AT1:

A

Angiotensin type 1 receptor

19
Q

ACE:

A

Angiotensin converting enzyme

20
Q

List the different drug class medications affecting RAAS:

A
  1. Direct renin inhibitor
  2. ACE inhibitors
  3. Angiotensin receptor blockers
  4. Aldosterone antagonsit
21
Q

Blocks renin activity on angiotensinogen:

A

Direct renin inhibitor

22
Q

Prevents ACE from converting angiotensin I to angiotensin II:

A

ACE inhibitors

23
Q

Blocks angiotensin II activity at the AT1 receptor:

A

Angiotensin II receptor blockers

24
Q

Blocks activity of aldosterone in the kidneys and other tissues (i.e. heart, smooth muscle):

A

Aldosterone antagonist

25
Q

Give an example of a direct renin inhibitor:

26
Q

Give an example of an ACE inhibitor:

A
  1. Captopril
  2. Enalapril
27
Q

Give an example of an angiotensin receptor blocker:

A
  1. Candesartan
  2. Valsartan
28
Q

Give an example of aldosterone antagonist:

A
  1. Eplerenone
  2. Spironolactone
29
Q

Aliskerin is a:

A

direct renin inhibitor

30
Q

-Direct renin inhibitor
-Used for HTN
-ADRs: diarrhea, dyspepsia, hypotension
-DDI: Increased levels when combined with CYP3A4 like macrolide antibiotics

31
Q

Dental implications for Aliskerin:

A
  1. monitor vital signs
  2. avoid standing patient up too fast
32
Q

the “prils”:

A

ACE inhibitors

33
Q

-Benazepril
-Captopril
-Enalapril
-Fosinopril
-Lisinopril
-Moexipril
-Perindopril
-Quinapril
-Ramipril
-Trandolapril

These are all:

A

ACE inhibitors (Prils)

34
Q

What acronym can be used to memorize the ADIs of ACE inhibitors? (list them)

A

CAPTOPRIL

C: Cough
A: Angioedema & Agranulocytosis & Acute renal insufficiency
P: Potassium excess (hyperkalemia) & Proteinuria
T: Taste change
O: Orthostatic hypotension
P: Pregnancy ** contraindication
R: Renal artery stenosis ** contraindication
I: Increased serum creatinine
L: Leukopenia & Liver toxicity

35
Q

Lisinopril is an example of:

A

ACE inhibitor

36
Q

Lisinopril can be used to treat:

A
  1. HTN
  2. HF
  3. Post-MI
  4. Kidney disease
37
Q

What are some dental implications for patients on ACE inhibitors?

A
  1. Orthostatic hypotension
  2. Monitor vitals
  3. Cough may cause lengthy procedures
  4. If dental surgery is anticipated evaluate risk of hypotensive episode
38
Q

The “sartans”:

A

Angiotensin receptor blockers

39
Q

-Azilsartan
-Candesartan
-Eprosartan
-Irbesartan
-Losartan
-Olmesartan
-Telmisartan
-Valsartan

These are all:

A

Angiotensin receptor blockers (Sartans)

40
Q

Angiotensin receptor blockers ADRs:

A

HDH

  1. Headache/Hypotension
  2. Dizziness
  3. Hyperkalemia
  4. Cough
  5. Angioedema
41
Q

What are angiotensin receptor blockers used to treat?

A
  1. Hypertension
  2. HF
  3. Kidney disease
42
Q

What are the DDIs of angiotensin receptor blockers?

A
  1. sedative meds –> increased anti-hypotensive effects
  2. NSAIDs –> reduced anti-hypertensive effect
  3. General anesthesia –> increased anti-hypertensive effect
43
Q

Dental implications of angiotensin receptor blockers:

A
  1. orthostatic hypotension
  2. monitor vital signs
  3. if dental surgery is anticipated evaluate risk of hypotensive episode

Intro to Pharmacology (16 decks)

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