vascular system Flashcards
(108 cards)
Renin
- released by the kidneys in response to decrese perfusion
RAAS
Angiotensinogen
- released by liver
- converted to angiotensin I by renin
Angiotensin I
- no known activity
- converted to angiotensin II by ACE
Angiotensin II
- causes vasoconstriction, salt retention, vascular growth
- stimulates release of aldosterone
Medications classes effecting the RAAS
Direct renin inhibitor
ACEi
Angiotensin receptor blockers
Aldosterone antagonists
Direct Renin Inhibitor
Mechanism of action
Aliskerin
direct renin inhibitor
Aliskerin MOA
Direct renin inhibitor- prevent conversion of
angiotensinogen to angiotensin I
Aliskerin ADRs
Diarrhea, dyspepsia, Hypotension
aliskerin drug interactions
Increased levels with?
Increased levels when combined with CYP3A4 inhibitors like macrolide antibiotics
Aliskerin dental implications
- Monitor vital signs
- After supine positioning, have patient sit upright
for at least 2 minutes before standing to avoid
orthostatic hypotension
ACEi MOA diagrammed
ACEi suffix
-pril
ACE Inhibitors
Adverse drug reactions/ contraindications
mneumonic?
C: Cough (up to 10%)
A: Angioedema (<1%) / Agranulocytosis (rare)
P: Potassium excess (hyperkalemia 1-10%)/Proteinuria (rare)
T: Taste change (2-4%)
O: Orthostatic hypotension (~5%)
P: Pregnancy (contraindication)
R: Renal artery stenosis- bilateral (contraindication)
I: Increased serum creatinine (1-10%- transient)
L: Leukopenia (rare) / Liver Toxicity (rare
lisinopril MOA
inhibits the angiotensin converting enzyme blocking the
conversion of angiotensin I to angiotensin II
lisinopril ADRs
Cough, angioedema, hypotension, acute renal
insufficiency, hyperkalemia, taste disturbances/dry mouth(rare)
Lisinopril drug interactions:
* NSAIDs
* Alcohol
* General anesthesia
- NSAIDs- reduced anti-hypertensive effect
- Alcohol- increased anti-hypertensive effect
- General anesthesia- increased anti-hypertensive effect
ACE Inhibitors
Dental Implications
- Orthostatic hypotension:
- After supine positioning, have patient sit upright for
at least 2 minutes before standing to avoid orthostatic
hypotension - Monitor vital signs
- ACE Inhibitor induced cough may make longer dental proceduresdifficult
- If dental surgery is anticipated evaluate risk of hypotensive episode
Angiotensin II Receptor Blockers
Mechanism of action diagram
Angiotensin Receptor blockers suffix
-sartan
Angiotensin Receptor Blockers
Adverse drug reactions
menumonic? do not cause?
Halt Dangerous Hypertension:
* Headache / Hypotension
* Dizziness
* Hyperkalemia
DO NOT CAUSE: Cough and Angioedema (probably)
candesartan MOA
Blocks the AT1 receptor of angiotensin II
candesartan ADRs
Hypotension, dizziness, and hyperkalemia