Targets for antihypertensive drugs

Question 1

Renin cleaves what?

Answer 1

Angiotensinogen to angiotensin 1

Question 2

Angiotensin converting enzyme is inhibited by what?

Answer 2

ACE inhibitors

Question 3

Bradykinin causes what in the vascular system

Answer 3

Vasodilation

Question 4

Which causes more vasoconstriction? Angiotensin 2 or 3?

Answer 4

Angiotensin 2

Question 5

Angiotensin 2 affects which angiotensin receptors?

Answer 5

AT receptor 1 and 2

Question 6

Angiotensin 3 affects which Angiotensin receptors?

Answer 6

Angiotensin receptor 1 and 2

Question 7

Effect of NaCl reabsorption at Macula Densa?

Answer 7

Inhibits Renin release

Question 8

Effect of Decrease in blood pressure in pre-glomerular vessels?

Answer 8

Inhibit of renin release

Question 9

Activation of B1 Adrenergic receptors on JGCs causes what?

Answer 9

Causes renin release

Question 10

Where are angiotensin 2 type 1 receptors located? (5)

Answer 10

Blood vessels, brain, adrenals, kidney, and heart

Question 11

Activation of AT1 receptors does what?

Answer 11

Increase BP

Question 12

Result of angiotensin 2 on altered cardiovascular structure?

Answer 12

Vascular and Cardiac Hypertrophy and remodeling

Question 13

Inhibitors of renin angiotensin system?

Answer 13

Direct Renin inhibitors
ACE inhibitors
Angiotensin receptor blockers

Question 14

Suffix that indicates an ACE inhibitor drug?

Answer 14

PRIL

Question 15

Besides angiotensin what else do ACE inhibitors inhibit?

Answer 15

Bradykinin

Question 16

What class of drugs would interfere with Bradykinin mediated vasodilation?

Answer 16

NSAIDS

Question 17

Characteristics of Captopril? (4)

Answer 17

Active site inhibitor
Short half life
Absorption reduced by food
Altered taste, rash

Question 18

Largest class of ACE inhibitors?

Answer 18

Dicarboxyl containing ACE inhibitors

Question 19

Characteristics of Enalopril? (3)

Answer 19

It’s a pro-drug
Long half life
Parenteral administration

Question 20

How are ACE inhibitors cleared from the body? Exception?

Answer 20

Renal

Moexipril cleared via hepatic

Question 21

How do ACE inhibitors compete?

Answer 21

Competitively

Question 22

Characteristics of Lisinopril? (3)

Answer 22

Not a prodrug
Lysine derivative of enalaprilat
Half life of 12 hours

Question 23

Characteristics of Fosinopril (3)

Answer 23

Prodrug
Hepatic metabolism with excretion in urine and bile
Half life of 11.5 hours

Question 24

Clinical uses of ACE inhibitors? (4)

Answer 24

Hypertension
Left Ventricular systolic dysfunction
Myocardial infarction
Diabetic Nephropathy

Question 25

Main adverse effects of ACE inhibitors? (3)

Answer 25

Acute renal failure Dry cough Skin rash

Question 26

When do you not want to use ACE inhibitors?

Answer 26

``` Pregnancy Renal insufficiency (causes neutropenia) ```

Question 27

Antacids have what effect on ACE inhibitors?

Answer 27

Reduce bioavailability

Question 28

NSAIDS have what effect on ACE inhibitors?

Answer 28

Reduce effectiveness

Question 29

ACE inhibitors increase plasma levels of what?

Answer 29

Digoxin and lithium

Question 30

ACE inhibitors can interact with what supplement?

Answer 30

K+ supplements

Question 31

What are the Angiotensin 2 Type 1 receptor antagonists known as?

Answer 31

The "Sartans"

Question 32

Do Angiotensin 2 Type 1 receptor antagonists affect Bradykinin system?

Answer 32

No

Question 33

Clinical uses for Angiotensin 2 Type 1 Receptor Antagonists? (4)

Answer 33

Hypertension Congestive Heart Failure Diabetic Nephropathy Stroke prophylaxis

Question 34

Adverse effects of A2T1R?

Answer 34

Hypotension Hyperkalemia Teratogenic potential (2nd and 3rd trimester)

Question 35

Side effect of Direct Renin inhibitor?

Answer 35

Diarrhea

Question 36

Effect of high fat meals on direct renin inhibitor absorption?

Answer 36

Decrease in absorption

Question 37

What are direct renin inhibitors used to treat?

Answer 37

Hypertension

Question 38

Who do you not want to you renin inhibitors on?

Answer 38

Pregnant | Nursing mothers