RAAS

Question 1

What enzyme starts the RAAS?

Answer 1

Renin

Question 2

What is the function of renin?

Answer 2

cleaves angiotensinogen into angiotensin I

Question 3

What is the function of ACE?

Answer 3

converts Ang I to Ang II

Question 4

What is the function of Ang II?

Answer 4

Powerful vasoconstrictor

Stimulates the release of aldosterone (increases blood pressure)

Causes remodeling and hypertrophy of the myocardium

Question 5

_____ _______ reflects angiotensinogen levels and renin activity.

Answer 5

Blood pressure

Question 6

Ang II is a potent ________.

Answer 6

vasoconstrictor

Question 7

Ang II stimulates _____ release.

Answer 7

ADH

Question 8

Ang II promotes Na _______ in the ________ tubule.

Answer 8

reabsorption

proximal

Question 9

Ang II increases _________ synthesis and secretion.

Answer 9

aldosterone

Question 10

What is the only direct renin inhibitor agent?

Answer 10

Aliskiren

Question 11

What are the adverse effects of Aliskiren?

Answer 11

Angioedema
Dry cough
Diarrhea
Hyperkalemia
Fetal injury

Question 12

In what groups is Aliskiren contraindicated?

Answer 12

pregnancy

those who have experienced angioedema

Question 13

Which ACE inhibitor(s) is(are) the most therapeutically effective?

Answer 13

none; they are all equally effective

Question 14

What are the clinical uses of ACE inhibitors?

Answer 14

Hypertension
Heart Failure (ripped hearts)
Diabetic nephropathy (delay renal injury by decreasing pressure in the glomerulus)
Myocardial infarction
Prevention of MI, stroke, and death in high risk patients

Question 15

What are the major adverse effects of ACE inhibitors?

Answer 15

First-dose hypotension

Dry cough (due to the stimulation of bradykninen)

Hyperkalemia (opponent has a lot of banana clips)

Renal failure in patients with bilateral renal artery stenosis

Fetal injury

Very rare cases of Angioedema (swollen face since the opponent was angry)

Question 16

What is the ending for ACE inhibitors?

Answer 16

-pril

Question 17

What is the MOA of ARBs?

Answer 17

block Ang II from binding to its receptor

Question 18

What conditions could be treated with ARBs and ACE inhibitors?

Answer 18

Hypertension
heart failure
diabetic nephropathy
Myocardial infarction
Prevention of MI, stroke, and death in high risk patients

Question 19

What are the adverse effects of ARBs?

Answer 19

Angioedema
Fetal harm
Renal failure

Question 20

What is the ending for ARBs?

Answer 20

-sartan

Question 21

What is the purpose of the RAAS?

Answer 21

It regulates our blood pressure, blood volume, fluids, and electrolytes (specifically when it happens to drop from normal levels).

It wants to activate Angiotensin 2 to help cause vasoconstriction (increase blood pressure)

Question 22

How does the RAAS work?

Answer 22

It converts Angiotensin 1 into Angiotensin 2 by using angiotensin-converting enzyme (ACE)

Question 23

When is renin produced by kidney?

Answer 23

In response to:

Low blood pressure
Low blood volume
Low sodium concentration

Question 24

When does renin production stop?

Answer 24

When the body’s blood pressure, blood volume, and sodium concentration becomes normal again

Question 25

What is the function of aldosterone?

Answer 25

Stimulates sodium retention (water follows) and potassium excretion, which increases blood pressure. Causes pathologic remodeling and hypertrophy of the myocardium

Question 26

What enzyme activates angiotensinogen?

Answer 26

Renin

Question 27

What substance activates angiotensin 1?

Answer 27

Angiotensinogen

Question 28

What is the order of the RAAS?

Answer 28

renin-> Angiotensinogen-> Angiotensin 1-> Angiotensin 2 (ACE helped with the conversion) ->Aldosterone (allows sodium retention)

Question 29

Function of ADH hormone

Answer 29

Allows water retention

Question 30

What does ACE inhibitors do to the body?

Answer 30

Inhibits Angiotensin-converting enzyme, which causes: vasodilation, decreases the heart's workload, and lowers blood pressure

Question 31

What effect does ACE inhibitors have on aldosterone?

Answer 31

It reduces aldosterone levels, causing sodium and water to excreted out of the body

Question 32

What is a rare adverse effect of ACE inhibitors

Answer 32

Angioedema

Question 33

What are the drug to drug interactions of ACE inhibitors and ARBs?

Answer 33

``` Diuretics (potential desirable and undesirable effects) Antihypertensive agents Drugs that raise potassium Lithium NSAIDs ```

Question 34

What is the physiologic effects of ACE inhibitors, ARBs, and direct renin inhibitors?

Answer 34

Vasodilation Decrease production of aldosterone Reduce cardiac remodeling Dilation of renal blood vessels

Question 35

What is the relationship between bradykinin and ACE inhibitors?

Answer 35

ACE inhibitors block kinase II from converting bradykinin into an inactive form (causes the dry cough adverse effect)

Question 36

What ACE inhibitor is given through IV?

Answer 36

Enalaprilat

Question 37

What drugs should not be given to pregnant women?

Answer 37

Angiotensin-converting enzyme inhibitors (ACE inhibitors) Angiotensin 2 receptor blockers (ARBs)

Question 38

What rare adverse effect is found in both ACE inhibitors, Angiotensin 2 inhibitors, and Direct renin inhibitors?

Answer 38

Angioedema

Question 39

What condition(s) could direct renin inhibitors treat?

Answer 39

Hypertension

Question 40

Mechanism of direct renin inhibitors

Answer 40

Binds to renin and prevents it from cleaving angiotensinogen to angiotensin I

Question 41

What are the adverse effects of direct renin inhibitors?

Answer 41

``` Diarrhea Angioedema (rare) Dry cough Hyperkalemia Fetal injury ```

Question 42

Eplerenone is _______ for aldosterone receptors, while spironolactone is _______.

Answer 42

1. Selective | 2. Non-selective