RAAS Drugs Flashcards
ACE
Angiotensin conversion enzyme- converts Angiotensin I to Angiotensin II, which is responsible for much of the damage in CV disease (pathologic fibrosis)
RAAS system
constricts renal blood vessels
acts on the kidneys to promote retention of sodium and water and the excretion of potassium
ACE inhibitors
-pril Reduce angiotensin II increase levels of bradykinin Used for hypertension heart failure MI diabetic and nondiabetic nephropathy (slows progression of kidney disease) Prevention of MI, stroke, and death in patients at high CV risk.
ACE inhibitors adverse effects
First-dose hypotension ACE cough- dry cough Angioedema- constricted airway- epinephrine (very rare) Fetal injury, malformations, death Hyperkalemia Dysgeusia and rash Renal failure
ACE inhibitors contraindications
In pts with stenosis (narrowing) of BOTH renal arteries- can end up with kidney failure
ACE Inhibitors interactions
Diuretics (especially if K sparing)
Antihypertensive agents- may cause hypotension
Lithium- levels go up too much
NSAIDs- blunt effects of ACE inhibitors
Angiotensin II receptor blockers
end in -sartan
Cause dilation of arterioles and veins
Prevents angiotensin II from inducing pathologic changes
Does not inhibit kinase II in lungs- no cough
Used for HTN, heart failure, MI, diabetic nephropathy
What drugs might be used to prevent CV issues in high-risk patients if ACE inhibitors aren’t tolerated well?
Angiotensin II receptor blockers (-sartan)
Adverse effects of Angiotensin II receptor blockers
Angioedema
Fetal harm
Renal failure
Aliskiren (tekturna)
Direct renin inhibitor
Binds tightly with renin, inhibits the cleavage of angiotensinogen to angiotensin I
Side effects of Aliskiren (tekturna)
Angioedema Cough GI effects Hyperkalemia Fetal Injury and death
Eplerenone (Inspra)
Selective blockade of aldosterone receptors
HTN and heart failure
Causes hyperkalemia
Spironolactone adverse effects
Hyperkalemia Gynecomastia Menstrual irregularities Impotence Hirsutism Deepening of the voice
