RAAS

Question 1

What stimulates the release of renin from the JGA?

Answer 1

decreased afferent blood pressure

decreased tubular NaCl (urine)

Question 2

What is the function of renin?

Answer 2

cleaves angiotensinogen into angiotensin I

Question 3

What is the function of ACE?

Answer 3

converts Ang I to Ang II

Question 4

What is the function of Ang II?

Answer 4

constricts the efferent arteriole to increase GFR

stimulates the release of aldosterone from adrenal

Question 5

Where/how is angiotensinogen released?

Answer 5

continuously from the liver

Question 6

Plasma levels of angiotensinogen are increased by what?

Answer 6

glucocorticoids
thyroid hormone
estrogen (pregnancy)
Ang II
inflammation
insulin

Question 7

_____ _______ reflects angiotensinogen levels and renin activity.

Answer 7

Blood pressure

Question 8

Ang II is a potent vaso________.

Answer 8

vasoconstrictor

Question 9

Ang II stimulates _____ release.

Answer 9

ADH

Question 10

Ang II promotes Na _______ in the ________ tubule.

Answer 10

reabsorption

proximal

Question 11

Ang II increases _________ synthesis and secretion.

Answer 11

aldosterone

Question 12

Renin is secreted as _______.

Answer 12

prorenin

Question 13

Pregnant women and diabetics have ________ levels of prorenin.

Answer 13

elevated

Question 14

The newest hypertensive on the market is of what class?

Answer 14

renin inhibitor

Question 15

What is the renin inhibitor agent?

Answer 15

Aliskiren

Question 16

Aliskiren decreases plasma renin activity by __-__%

Answer 16

50 - 80%

Question 17

Aliskiren ______ Ang I and Ang II levels.

Answer 17

decreases

Question 18

Aliskiren decreases BP by __-__ mm Hg.

Answer 18

10-15

Question 19

Aliskiren _____ plasma renin concentration.

Answer 19

increases

Question 20

Aliskiren is dosed how often?

Answer 20

daily

Question 21

What are the adverse effects of Aliskiren?

Answer 21

mild diarrhea
suppression of hematopoiesis
hyperkalemia

Question 22

In what groups is Aliskiren contraindicated?

Answer 22

pregnancy

those who have experienced angioedema

Question 23

ACE ______ bradykinin.

Answer 23

decreases

Question 24

Bradykinin is a vaso______ that promotes ___ and ____ loss.

Answer 24

vasodilator
Na
water

Question 25

Inhibition of ACE creates what effects?

Answer 25

decrease in Ang II increase in bradykinin vasodilation and diuresis

Question 26

Where is ACE located?

Answer 26

on the luminal surface of the endothelial and kidney epithelial cells

Question 27

ACE inhibitors ______ plasma renin levels.

Answer 27

increase

Question 28

ACE inhibitors ______ plasma Ang I levels.

Answer 28

increase

Question 29

ACE inhibitors ______ bradykinin degradation.

Answer 29

decrease

Question 30

What are the 3 classes of ACE inhibitors?

Answer 30

sulfhydryls dicarboxylates phosphonates

Question 31

Which ACE inhibitor(s) is(are) the most therapeutically effective?

Answer 31

none; they are all equal

Question 32

What are the clinical uses of ACE inhibitors?

Answer 32

``` HTN CHF left ventricular dysfunction post MI diabetic and nondiabetic neuropathy ```

Question 33

What are the major adverse effects of ACE inhibitors?

Answer 33

``` hypotension cough angioedema skin rash dysgeusia neutropenia hyperkalemia ```

Question 34

In what groups are ACE inhibitors contraindicated?

Answer 34

pregnancy bilateral renal stenosis severe CHF

Question 35

What is the ending for ACE inhibitors?

Answer 35

-pril

Question 36

The affinity of ARBs is so much ______ than Ang II that it is essentially ________.

Answer 36

greater | insurmountable

Question 37

ARBs are not effective in _______ HTN.

Answer 37

low-renin

Question 38

What is the MOA of ARBs?

Answer 38

block the activity of Ang II on the Ang II receptor and thus decreasing aldosterone and ADH secretion

Question 39

What are the therapeutic uses of ARBs?

Answer 39

HTN heart failure diabetic neuropathy

Question 40

What are the adverse effects of ARBs?

Answer 40

not different than placebo

Question 41

Combining ACE inhibitors with ARBs can lead to what?

Answer 41

hyperkalemia | kidney injury

Question 42

What groups are ARBs contraindicated in?

Answer 42

pregnancy | careful use in renally compromised patients

Question 43

What is the ending for ARBs?

Answer 43

-artan

Question 44

What is Entresto?

Answer 44

A combination of ARB with sacubitril (a neprilysin inhibitor)

Question 45

In what population is Entresto recommended?

Answer 45

heart failure