RAAS targeting drugs

Question 1

Ramipril drug type

Answer 1

ACE inhibitor (angiotensin converting enzyme)

Question 2

Valsartan drug type

Answer 2

ARB (Angiotensin receptor blockers)

Question 3

Spironolactone Drug type

Answer 3

MRA (mineralocorticoid receptor antagonists)

Question 4

What accumulates with ace inhibitors and its consequence

Answer 4

vasoactive peptides (Bradykinin) which lead to dry cough

Question 5

Where does ACE inhibition occur

Answer 5

endothelial cells throughout circulation

Question 6

3 uses of ace inhibitors and how

Answer 6

High BP (vasodilator, lower aldosterone)
Chronic Kidney disease (lower renal pressure)
Heart failure and ischemic heart disease (lower effects of angiotensin 2 and aldosterone on damaged muslce)

Question 7

Cautions of ACE inhibitor

Answer 7

Reduced BP
Dry cough
Hyperkalemia (High K from aldosterone inhibition)
Lowered kidney perfusion in vulnerable patients

Question 8

What do ARBs inhibit

Answer 8

AT-1 receptor, blocks angiotensin 2
(same action as ACE, different target)

Question 9

What are ACEI and ARB first-line agents for

Answer 9

Chronic kidney disease (before other BP drugs)

Question 10

How to ACEI and ARBs do renal protection

Answer 10

RAAS is high and causes lots of extra pressure, RAAS will increase amount of proteins leaking.
These drugs work to reduce pressure and damage progression

Question 11

Kidney Effect Cautions of ACEI and ARB

Answer 11

-vulnerable patient with poor renal flow (dehydrated), renin levels will increase. causing aldosteron release and fluid retention
-can cause acute renal failure

Question 12

Direct renin inhibitors MOA

Answer 12

Bind to active site of renin and block conversion of angiotensinogen to angiotensin 1

Question 13

Uses of MRA

Answer 13

-specific CV situations
-resistant hypertension (excess aldosterone)
-heart failure (block aldosterone)

Question 14

MRA cautions

Answer 14

-increase K from RAAS blocking
-hormonal effect of gynecomastia tissue growth