Chapter 31 ACEI and ARBS

Question 1

What is the last name for ARBS

Answer 1

“-sartan”

Question 2

What is the last name for ACEI’s

Answer 2

“-pril”

Question 3

what is the prototype ARBS

Answer 3

Losartan

Question 4

What is the prototype ACEI

Answer 4

Lisinopril

Question 5

what are the 4 steps of the Renin Angiotensin aldosterone system

Answer 5

1. Angiotensinogen is produced by the liver
2. Angiotensinogen is converted to angiotensin 1 by renin which is secreted by the kidneys
3. ACE secreted from the lungs converts Angiotensin 1 to angiotensin 2
4. Angiotensin 2 causes vasoconstriction and releases aldosterone and ADH

Question 6

why can ACEI’s create angioedema

Answer 6

because ACE is also responsible for the breakdown of bradykinin which is a mediator of inflammation

Question 7

What are three indications for ACEI’s

Answer 7

-Heart failure
-Recent MI
-If patient is in danger of kidney damage from HTN

Question 8

What are contraindications for ACEI’s and ARBS

Answer 8

-Hyperkalemia (because ACEI messes with excretion of K+)
-Symptomatically hypotensive (will tank the PT)
-Renal failure (since ACEI are excreted by the kidneys)

Question 9

What are adverse effects of ACEI

Answer 9

-Cough (build up of bradykinin)
-Orthostatic hypotension
-Angioedema

Question 10

What are considerations for ACEI

Answer 10

-Check lab levels of K+
-Check BP before administration and 30 min to 1 hour after

Question 11

What are drug interactions for ACEI and ARBS

Answer 11

-K+ supplements (ACEI and ARBS both reduce the excretion of K+ from the kidneys)
-other drugs that lower BP
-NSAIDS because they decrease effectiveness

Question 12

what are ARBS effect on bradykinin

Answer 12

they do not affect the breakdown of bradykinin so they do not produce a cough like ACEI do

Question 13

What pregnancy category are ACEI and ARBS

Answer 13

Both are pregnancy category D

Question 14

what is one downside of ARBS compared to ACEI

Answer 14

ARBS are more expensive than ACEI