Week 7: ACE and ARBs Flashcards
What is the goal of the Renin-Angiotensin-Aldosterone System?
a) decrease blood pressure
b) increase the heart rate
c) increase the blood pressure
d) decrease the heart rate
c) increase the blood pressure
When the RAAS is activated due to a change in body hemodynamics, the __________ stimulates the __________ cells in the kidneys to release_________.
a) parasympathetic nervous system; mesangial; aldosterone
b) sympathetic nervous system; podocytes; renin
c) parasympathetic nervous system; juxtaglomerular; aldosterone
d) sympathetic nervous system; juxtaglomerular; renin
d) sympathetic nervous system; juxtaglomerular; renin
What component of the RASS system is created and found in the liver that is activated by renin?
a) aldosterone
b) Angiotensin I
c) Angiotensinogen
d) Angiotensin II
c) Angiotensinogen
What is the role of ACE in the RAAS?
a) it activate angiotensinogen which turns into angiotensin I
b) it causes the kidney cells to release renin
c) it causes angiotensin II to trigger the adrenal glands to produce aldosterone
d) it converts angiotensin I into angiotensin II
d) it converts angiotensin I to angiotensin II
Select all the roles of angiotensin II when it is activated in the RAAS:
a) activates bradykinin
b) triggers the release of aldosterone
c) increases the blood volume
d) causes vasodilation
e) Increases systemic vascular resistance
f) causes the release of ADH (antidiuretic hormone)
b) triggers the release of aldosterone
c) increases the blood volume
e) Increases systemic vascular resistance
f) causes the release of ADH (antidiuretic hormone)
During RAAS activation, what gland releases aldosterone?
a) hypothalamus
b) thymus
c) adrenal cortex
d) pituitary
c) adrenal cortex
What is the role of aldosterone?
a) it causes a constriction of vessels
b) it causes the kidneys to keep sodium and water
c) it causes the kidneys to keep potassium and water
d) it causes the kidneys to only keep water
b) it causes the kidneys to keep sodium and water
Select below the CORRECT sequence in how the RAAS system works:
a) Angiotensin I -> Angiotensin II -> ACE -> Renin -> Angiotensinogen
b) Renin-> Angiotensinogen -> Angiotensin I -> ACE -> Angiotensin II
c) Renin -> Angiotensin I -> Angiotensinogen -> ACE -> Angiotensin II
d) Angiotensinogen -> Renin -> ACE -> Angiotensin I -> Angiotensin II
b) Renin-> Angiotensinogen -> Angiotensin I -> ACE -> Angiotensin II
What are ACE inhibitors used to treat?
- HTN (prevent vasoconstriction; proteinuric diabetes)
- angina
- Heart failure (cardiac protective)
- Heart attack (post MI)
- Kidney disease (renal protective)
- CAD/Atherosclerosis
What is the MOA of ACE inhibitors?
- inhibit the conversion of angiotensin I to angiotensin II which leads to a decrease in peripheral vascular resistance
- inhibit the degradation of bradykinin and increase the synthesis of vasodilating prostaglandins
ACE inhibitors/ARBs cautions/ contraindications
- Do not use in pregnancy
- Do not use in bilateral renal artery stenosis
- Avoid in pts w/ angioedema
- avoid w/ other medications that cause hyperkalemia
ACE inhibitor/ARBs ADRs
- dry cough (URIs in ARBs)
- hyperkalemia
- angioedema (not as much risk in ARBs)
- dizziness, fatigue, skin rash, altered taste
ACE-I/ARBs patient education
- do not double dose if one is missed
- hypotension is the most common adverse drug effect
- cough is common with older-generation agents
What are ARBs (Angiotensin II Receptor Blockers) used to treat? “-sartans”
- HTN (proteinuria diabetes)
- Heart Failure
- Heart Attack (post MI)
- Kidney Disease
- CAD/Atherosclerosis, ischemic heart disease
How do ARBs work?
Block the Angiotensin II receptors in the kidney, brain, heart, and arterial walls - by reducing the action of angiotensin II at the receptor sites, there is a reduction of vasoconstriction and in aldosterone secretion, which reduces the retention of sodium and water
