RAAS Flashcards
What enzyme starts the RAAS?
Renin
What is the function of renin?
cleaves angiotensinogen into angiotensin I
What is the function of ACE?
converts Ang I to Ang II
What is the function of Ang II?
Powerful vasoconstrictor
Stimulates the release of aldosterone (increases blood pressure)
Causes remodeling and hypertrophy of the myocardium
_____ _______ reflects angiotensinogen levels and renin activity.
Blood pressure
Ang II is a potent ________.
vasoconstrictor
Ang II stimulates _____ release.
ADH
Ang II promotes Na _______ in the ________ tubule.
reabsorption
proximal
Ang II increases _________ synthesis and secretion.
aldosterone
What is the only direct renin inhibitor agent?
Aliskiren
What are the adverse effects of Aliskiren?
Angioedema Dry cough Diarrhea Hyperkalemia Fetal injury
In what groups is Aliskiren contraindicated?
pregnancy
those who have experienced angioedema
Which ACE inhibitor(s) is(are) the most therapeutically effective?
none; they are all equally effective
What are the clinical uses of ACE inhibitors?
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
What are the major adverse effects of ACE inhibitors?
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)
What is the ending for ACE inhibitors?
-pril
What is the MOA of ARBs?
block Ang II from binding to its receptor
What conditions could be treated with ARBs and ACE inhibitors?
Hypertension heart failure diabetic nephropathy Myocardial infarction Prevention of MI, stroke, and death in high risk patients
What are the adverse effects of ARBs?
Angioedema
Fetal harm
Renal failure
What is the ending for ARBs?
-sartan
What is the purpose of the RAAS?
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)
How does the RAAS work?
It converts Angiotensin 1 into Angiotensin 2 by using angiotensin-converting enzyme (ACE)
When is renin produced by kidney?
In response to:
Low blood pressure
Low blood volume
Low sodium concentration
When does renin production stop?
When the body’s blood pressure, blood volume, and sodium concentration becomes normal again
What is the function of aldosterone?
Stimulates sodium retention (water follows) and potassium excretion, which increases blood pressure.
Causes pathologic remodeling and hypertrophy of the myocardium
What enzyme activates angiotensinogen?
Renin
What substance activates angiotensin 1?
Angiotensinogen
What is the order of the RAAS?
renin-> Angiotensinogen-> Angiotensin 1-> Angiotensin 2 (ACE helped with the conversion) ->Aldosterone (allows sodium retention)
Function of ADH hormone
Allows water retention
What does ACE inhibitors do to the body?
Inhibits Angiotensin-converting enzyme, which causes: vasodilation, decreases the heart’s workload, and lowers blood pressure
What effect does ACE inhibitors have on aldosterone?
It reduces aldosterone levels, causing sodium and water to excreted out of the body
What is a rare adverse effect of ACE inhibitors
Angioedema
What are the drug to drug interactions of ACE inhibitors and ARBs?
Diuretics (potential desirable and undesirable effects) Antihypertensive agents Drugs that raise potassium Lithium NSAIDs
What is the physiologic effects of ACE inhibitors, ARBs, and direct renin inhibitors?
Vasodilation
Decrease production of aldosterone
Reduce cardiac remodeling
Dilation of renal blood vessels
What is the relationship between bradykinin and ACE inhibitors?
ACE inhibitors block kinase II from converting bradykinin into an inactive form (causes the dry cough adverse effect)
What ACE inhibitor is given through IV?
Enalaprilat
What drugs should not be given to pregnant women?
Angiotensin-converting enzyme inhibitors (ACE inhibitors)
Angiotensin 2 receptor blockers (ARBs)
What rare adverse effect is found in both ACE inhibitors, Angiotensin 2 inhibitors, and Direct renin inhibitors?
Angioedema
What condition(s) could direct renin inhibitors treat?
Hypertension
Mechanism of direct renin inhibitors
Binds to renin and prevents it from cleaving angiotensinogen to angiotensin I
What are the adverse effects of direct renin inhibitors?
Diarrhea Angioedema (rare) Dry cough Hyperkalemia Fetal injury
Eplerenone is _______ for aldosterone receptors, while spironolactone is _______.
- Selective
2. Non-selective
