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The Vascular System 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 vasoconststriction, salt retention & vascular growth

A

angiotensin II

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5
Q

Angiotensin II stimulates the release of:

A

aldosterone

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6
Q

Decreased renal perfusion pressure leads to: (3)

A
  1. INCREASED renin release
  2. INCREASED renal sympathetic activity
  3. DECREASED glomerular filtration
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7
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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8
Q

Angiotensinogen acts on :

A

Angiotensin I

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9
Q

Angiotensin I is acted on by ____ to produce angiotensin II

A

ACE

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10
Q

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

A

ACE: No angiotensin II production

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11
Q

Angiotensin II acts on ____ receptors

A

AT1

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12
Q

What are the receptor antagonists for AT1 receptors?

A

Angiotensin II AT1 subtype receptor antagonists

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13
Q

What are the 3 effects of angiotensin II acting on AT1 receptors?

A
  1. vascular growth
  2. vasconstriction
  3. salt retention
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14
Q

Describe the vascular growth caused by angiotensin II:

A
  1. hyperplasia
  2. hypertrophy
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15
Q

Describe the vasoconstriction caused by angiotensin II:

A
  1. Direct
  2. Via increased noradrenaline release from sympathetic nerves
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16
Q

Describe the salt retention caused by angiotensin II:

A
  1. Aldosterone secretion
  2. Tubular Na+ resorption
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17
Q

AT1:

A

angiotensin 1 receptor

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18
Q

ACE:

A

angiotensin converting enzyme

19
Q

List the different drug class medications effecting RAAS:

A
  1. Direct renin inhibitor
  2. ACE inhibitors
  3. Angiotensin receptor blockers
  4. Aldosterone agonists
20
Q

Blocks renin activity on angiotensinogen:

A

Direct renin inhibitor

21
Q

Prevents ACE from converting angiotensin 1 to angiotensin 2

A

ACE inhibitors

22
Q

Blocks angiotensin II activity at the AT1 receptor:

A

Angiotensin receptor blockers

23
Q

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

A

Aldosterone antagonists

24
Q

Give an example of a direct renin inhibitor:

25
Q

Give an example of an ACE inhibitor:

A
  1. Captopril
  2. Enalapril
26
Q

Give an examples of an angiotensin receptor blockers:

A
  1. Candesartan
  2. Valsartan
27
Q

Give an example of aldosterone antagonists:

A
  1. Eplerenone
  2. Spironolactone
28
Q

Aliskerin is a:

A

direct renin inhibitor

29
Q
  • Direct renin inhibitor
  • Used for hypertension
  • ADRs: diarrhea, dyspepsia, and hypotension
  • DDI: Increased levels when combined with CYP3A4 Inhibitors like macrolide antibiotics
30
Q

Dental implications for aliskerin:

A
  1. monitor vital signs
  2. avoid sitting patient tup too fast
31
Q

the “prils” =

A

ACE inhibitors

32
Q
  • Benazepril
  • Captopril
  • Enalapril
  • Fosinopril
  • Lisinopril
  • Moexopril
  • Perindopril
  • Quinapril
  • Ramipril
  • Trandolapril
A

ACE INHIBITORS

33
Q

What acronym can be used for adverse drug reactions of ACE inhibitors? (list them out)

A

CAPTOPRIL

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

34
Q

Lisinopril is an example of:

A

ACE inhibitor

35
Q

Lisinopril can be used to treat:

A
  1. HTN
  2. HF
  3. Post MI
  4. Kidney disease
36
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
37
Q

The “sartans”

A

angiotensin receptor blockers

38
Q
  • Azilsartan
  • Candesartan
  • Eprosaarton
  • Irbesartan
  • Losartan
  • Olmesartan
  • Telmisartan
  • Valsartan
A

Angiotensin receptor blockers (sartans)

39
Q

Angiotensin receptor blockers ADRs:

A

HDH:

  1. Headache/ Hypotension
  2. Dizziness
  3. Hyperkalemia
  4. Cough
  5. Angioedema
40
Q

What are angiotensin receptor blockers used for?

A
  1. hypertension
  2. HF
  3. Kidney disease
41
Q

Drug-Drug Interactions for angiotensin receptor blockers:

A
  1. Sedative meds- increased anti-hypotensive effects
  2. NSAIDs- reduced anti-hypertensive effect
  3. General anesthesia- increased anti-hypertensive effect
42
Q

Dental implications for angiotensin receptor blockers:

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

Pharmacology (6 decks)

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