The Vascular System

Question 1

released by the kidneys in response to decreased perfusion

Answer 1

renin

Question 2

Released by the liver and converted to angiotensin I by renin

Answer 2

Angiotensinogen

Question 3

Activity unknown; converted to angiotensin II by ACE

Answer 3

Angiotensin I

Question 4

Causes vasoconststriction, salt retention & vascular growth

Answer 4

angiotensin II

Question 5

Angiotensin II stimulates the release of:

Answer 5

aldosterone

Question 6

Decreased renal perfusion pressure leads to: (3)

Answer 6

1. INCREASED renin release
2. INCREASED renal sympathetic activity
3. DECREASED glomerular filtration

Question 7

What three scenarios lead to INCREASED renin release?

Answer 7

1. Decreased renal perfusion pressure
2. Decreased glomerular filtration
3. Increased renal sympathetic nerve activity

Question 8

Angiotensinogen acts on :

Answer 8

Angiotensin I

Question 9

Angiotensin I is acted on by ____ to produce angiotensin II

Answer 9

ACE

Question 10

What do ACE inhibitors decrease? What does this lead to?

Answer 10

ACE: No angiotensin II production

Question 11

Angiotensin II acts on ____ receptors

Answer 11

AT1

Question 12

What are the receptor antagonists for AT1 receptors?

Answer 12

Angiotensin II AT1 subtype receptor antagonists

Question 13

What are the 3 effects of angiotensin II acting on AT1 receptors?

Answer 13

1. vascular growth
2. vasconstriction
3. salt retention

Question 14

Describe the vascular growth caused by angiotensin II:

Answer 14

1. hyperplasia
2. hypertrophy

Question 15

Describe the vasoconstriction caused by angiotensin II:

Answer 15

1. Direct
2. Via increased noradrenaline release from sympathetic nerves

Question 16

Describe the salt retention caused by angiotensin II:

Answer 16

1. Aldosterone secretion
2. Tubular Na+ resorption

Question 17

AT1:

Answer 17

angiotensin 1 receptor

Question 18

ACE:

Answer 18

angiotensin converting enzyme

Question 19

List the different drug class medications effecting RAAS:

Answer 19

1. Direct renin inhibitor
2. ACE inhibitors
3. Angiotensin receptor blockers
4. Aldosterone agonists

Question 20

Blocks renin activity on angiotensinogen:

Answer 20

Direct renin inhibitor

Question 21

Prevents ACE from converting angiotensin 1 to angiotensin 2

Answer 21

ACE inhibitors

Question 22

Blocks angiotensin II activity at the AT1 receptor:

Answer 22

Angiotensin receptor blockers

Question 23

Blocks the activity of aldosterone in the kidneys and other tissues (i.e. heart, smooth muscle)

Answer 23

Aldosterone antagonists

Question 24

Give an example of a direct renin inhibitor:

Answer 24

Aliskiren

Question 25

Give an example of an ACE inhibitor:

Answer 25

1. Captopril 2. Enalapril

Question 26

Give an examples of an angiotensin receptor blockers:

Answer 26

1. Candesartan 2. Valsartan

Question 27

Give an example of aldosterone antagonists:

Answer 27

1. Eplerenone 2. Spironolactone

Question 28

Aliskerin is a:

Answer 28

direct renin inhibitor

Question 29

- Direct renin inhibitor - Used for hypertension - ADRs: diarrhea, dyspepsia, and hypotension - DDI: Increased levels when combined with CYP3A4 Inhibitors like macrolide antibiotics

Answer 29

Aliskerin

Question 30

Dental implications for aliskerin:

Answer 30

1. monitor vital signs 2. avoid sitting patient tup too fast

Question 31

the "prils" =

Answer 31

ACE inhibitors

Question 32

- Benazepril - Captopril - Enalapril - Fosinopril - Lisinopril - Moexopril - Perindopril - Quinapril - Ramipril - Trandolapril

Answer 32

ACE INHIBITORS

Question 33

What acronym can be used for adverse drug reactions of ACE inhibitors? (list them out)

Answer 33

CAPTOPRIL C: Cough A: Angioedema & Agranulocytosis & Acute renal insufficiency P: Potassium excess (hyperkalemia) & Proteinuria T: Taste change O: Orthostatic hypotesnion P: Pregnancy (contraindication) R: Renal artery stenosis (contraindication) I: Increased serum creatinine L: Leukopenia & Liver toxicity

Question 34

Lisinopril is an example of:

Answer 34

ACE inhibitor

Question 35

Lisinopril can be used to treat:

Answer 35

1. HTN 2. HF 3. Post MI 4. Kidney disease

Question 36

What are some dental implications for patients on ACE inhibitors?

Answer 36

1. Orthostatic hypotension 2. Monitor vitals 3. Cough may cause lengthy procedures 4. If dental surgery is anticipated, evaluate risk of hypotensive episode

Question 37

The "sartans"

Answer 37

angiotensin receptor blockers

Question 38

- Azilsartan - Candesartan - Eprosaarton - Irbesartan - Losartan - Olmesartan - Telmisartan - Valsartan

Answer 38

Angiotensin receptor blockers (sartans)

Question 39

Angiotensin receptor blockers ADRs:

Answer 39

HDH: 1. Headache/ Hypotension 2. Dizziness 3. Hyperkalemia 4. Cough 5. Angioedema

Question 40

What are angiotensin receptor blockers used for?

Answer 40

1. hypertension 2. HF 3. Kidney disease

Question 41

Drug-Drug Interactions for angiotensin receptor blockers:

Answer 41

1. Sedative meds- increased anti-hypotensive effects 2. NSAIDs- reduced anti-hypertensive effect 3. General anesthesia- increased anti-hypertensive effect

Question 42

Dental implications for angiotensin receptor blockers:

Answer 42

1. orthostatic hypotension 2. monitor vital signs 3. if dental surgery is anticipated, evaluate risk of hypotensive episode