CV agents C8

Question 1

MOA Acei and monitoring
ramipril, peridonipril

Answer 1

ACE inhibitor
block the conversion of angiotensin 1 to angiotensin 2 by inviting the angiotensin converting enzyme (ACE)
angiotensin 2 is related to vasoconstriction, raising blood pressure.
The blockage of its formation leads to marinating vasodilation and keeping blood pressure low.

Monitoring: U&Es (↑ K⁺, ↓ renal function), BP
Counselling: First dose hypotension, cough (ACEi), regular blood tests, avoid K⁺ supplements.

Question 2

MOA ARB and monitoring
lostartan

Answer 2

These are angiotensin receptor blockers that prevent the binding of angiotensin 2 to the angiotensin receptor.
The angiotensin receptor when active, stimulates vasoconstriction, increasing blood pressure.

Monitoring: U&Es (↑ K⁺, ↓ renal function), BP
Counselling: First dose hypotension, cough (ACEi), regular blood tests, avoid K⁺ supplements.

Question 3

MOA beta blockers & monitoring
bisoprolol

Answer 3

• Selectively blocks beta 1 adrenoceptors mainly found in the heart and kidney. Blocking this reduces the adrenaline effect on the heart = causing a slower heart rate and relaxed blood vessels
• Reduced sympathetic drive od adrenaline to the heart – reducing cardiac output

Monitoring: HR, BP
Counselling: Don’t stop suddenly. May feel tired initially. Caution in asthma.

Question 4

MOA, use and monitoring: ivabradine

Answer 4

used in angina and CHF
inhibits If channels in heart, These channels are responsible for controlling the pacemaker current, which regulates the heart rate. By blocking these channels, ivabradine slows down the heart rate without affecting the force of contraction or blood pressure

common side effects:
arrhythmias
AV block
dizziness
headache
hypertension

Question 5

what is initiated in somoeone presenting with CCF

Answer 5

ACEi and beta blocker

Question 8

what is RAAS

Answer 8

renin-angiotensin-aldosterone system

hormone system that regulates blood pressure, fluid, and electrolyte balance, and systemic vascular resistance.

↓ BP or ↓ Na⁺ → Kidney releases renin
Renin converts angiotensinogen → angiotensin I
ACE converts angiotensin I → angiotensin II
Angiotensin II:
Causes vasoconstriction
Stimulates aldosterone release (from adrenal cortex)
↑ Na⁺ and water reabsorption → ↑ BP

Question 9

how do ARBs influence the RAAS

Answer 9

block angiotensin receptors - stop angiotensin 2 drom binding to receptors on vessels.
no release of aldosterone from adrenal cortex
= lowers bp (no vasoconstriction of vessels or increase in water&Na reabsobtion in collecting duct)