Cardio: ACE, ARBs, Aliskiren Flashcards Preview

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Flashcards in Cardio: ACE, ARBs, Aliskiren Deck (12)
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1
Q

Renin is produced, stored, and released from _____________.

A

the juxtaglomerular apparatus

2
Q

Explain the action of angiotensin II on GFR.

A

It causes the efferent arteriole to constrict, which preserves GFR. This is important because in low-volume states, the kidneys might not have the pressure needed to filter the blood.
(Think of the guy with two tense red suspenders sipping coffee from the Grounds Filter Rate machine.)

3
Q

Angiotensin II acts on the ____________ to directly stimulate increased sodium reabsorption.

A

PCT (Think of the guy watching the Pro Cart Track TV eating salty peanuts.)

4
Q

ACE inhibitors and angiotensin-receptor blockers can cause a temporary increase in creatinine. Why?

A

Because they temporarily decrease GFR; think, if angiotensin increases GFR by constricting the efferent arteriole, then ACE inhibitors decrease GFR by dilating the efferent arteriole.

5
Q

ACE inhibitors can cause ________________ because of the sudden decrease in vasoconstriction.

A

hypotension

6
Q

ACE inhibitors reduce mortality in those with _____________.

A

MI and heart failure (Think of the guardian angel flying above the couple.)

7
Q

Beta-blockers and ACE inhibitors decrease the ______________ after MIs.

A

undesired remodeling

8
Q

Patients with hypertension and _______________ should be given an ACE inhibitor.

A

albuminuria (think of the ALBUM in the Diasweeties Shop with high pressure pipes)

9
Q

In what situations would you not use an ACE inhibitor?

4

A

Pregnancy
(think of the tarantula on the jacket of the woman being escorted out)
C1 esterase deficiency
(a hereditary condition of angioedema in which people lack the enzyme that inhibits the complement pathway; think of the girl with the C-shaped lip ring)
NSAID use (Fire extinguisher in cracked kidney case)
Bilateral renal artery stenosis (the two purses with red straps)

10
Q

Watch out in using ACE inhibitors and ARBs in those with _______-kalemia.

A

hyper (as both cause this by counteracting the sodium-potassium exchanger in the collecting duct)

11
Q

What is the mechanism of aliskiren?

A

It is a direct renin inhibitor, thus preventing the conversion of angiotensinogen to angiotensin I.

12
Q

Caution in using ACE inhibitors in those with a history of arterosclerosis, why?

A

Bilateral Renal Artery Stenosis; in these patients GFR is maintaines thru the constriction of both arterioles. If given an ACE inhibitor vasodilation could drop GFR significantly leading to acute renal failure