Drugs Acting Of The RAAS

Question 1

What are the MOA of ACEIs and ARBs?

Answer 1

ACEIs block the production of angiotensin II.

ARBs block the actions of angiotensin II.

Question 2

ARBs have a much lower risk for ________ and _________.

Answer 2

Cough/hyperkalemia

Question 3

How does ACEIs cause cough and angioedema?

Answer 3

It increase levels of bradykinin through inhibition of kinase II which causes vasodilation

Question 4

ACEIs can cause severe renal insufficiency in pts with?

Answer 4

Bilateral renal artery stenosis or stenosis in the artery to a single remaining kidney.

Question 5

What is Aliskarin? What is its only approved indication?

Answer 5

Aliskarin is a direct renin inhibitor that acts on renin to inhibit the conversion of angiotensinogen into angiotensin. It is only approved for treat HTN.

Question 6

When Aliskarin is combine with Losartan in diabetic patients, what is developed?

Answer 6

Renoprotection

Question 7

When are maximal effects of Aliskarin seen? Half life?

Answer 7

Maximal effects in 2 weeks. Half life is 24 hours

Question 8

What are indications and therapeutic uses of ACEIs?

Answer 8

Indications: HTN, diabetic neuropathy, MI

Uses: HTN, HF (improves regional blood flow by lowering arterial tone, reduce afterload, increases CO), MI, diabetic and non diabetic neuropathy, diabetic retinopathy, and prevention of MI, stroke, and death in pts w/ high CV risk

Question 9

Which ACEIs cannot be given with food?

Answer 9

Moexipril and Captopril

Question 10

Which ACEI can only be administered IV?

Answer 10

Enalaprilat

Question 11

Which ACEI is the only one approved for neuropathy? Which can reduce risk for diabetic retinopathy?

Answer 11

Captopril for neuropathy.

Enalapril for diabetic retinopathy.

Question 12

Which ACEI is approved for reducing the risk of MI, stroke, and death in patients with high CV risk?

Answer 12

Ramipril

Question 13

What are adverse effects of ACEIs? What should be monitored?

Answer 13

AE: renal failure, angioedema (d/c and never use again), neutropenia, first dose hypotension, cough, hyperkalemia.

Monitor for hyperkalemia and creatinine 2-4 weeks after initiation then annually.

Question 14

What is the Black Box Warning for ACEIs?

Answer 14

2nd and 3rd trimester the ACEI can cause fetal injury. Specific effects: hypotension, hyperkalemia, skull hypoplasia, pulmonary hypoplasia, anuria, renal failure, and death. Women who become pregnant should d/c use. Exposed infants should be monitored for oliguria, hypotension, and hyperkalemia.

Question 15

What ARBs are approved for use in HF?

Answer 15

Valsartan and Candesartan

Question 16

Which ARBs are approved for used in type II diabetics with neuropathy?

Answer 16

Irbesartan and Losartan

Question 17

Which ARB is approved for reducing CV mortality in post MI patients with HF or LV dysfunction?

Answer 17

Valsartan

Question 18

Which ARB is used for stroke prevention and diabetic retinopathy?

Answer 18

Losartan

Question 19

Which ARB is approved for reducing risk for MI, stroke, and death from CV causes in patients 55 years and older?

Answer 19

Telmisartan

Question 20

Which aldosterone antagonist can improve symptoms of HF, reduce hospitalization, and prolong life?

Answer 20

Eplerenone