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FIU ACE-I and ARBs
ACE-I and ARBs
11
Pharmacology
Professional
12/20/2011

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Cards

Term
ARBs mechanism of action
Definition
Block AT1 (angiotensin II subtype I) receptors, prevents constriction of arterioles.
Term
ACE-I (angiotensin converting enzyme inhibitor)effect; side effect.
Definition
decreases angiotensin levels, less sodium and water absorbed and lower blood pressure; increased bradykinin (inactivated by ACE), which also decreases bp thru NO release and vasodilation BUT is a PRO-inflammatory cytokine (irritation of lungs = cough)
Term
-pril
Definition
ACE-inhibitors
Term
Captopril and lisinopril, side effect?
Definition
only prils that aren't PROdrugs (which must be metabolized to activate); captopril contains S = allergic rxn and CAI, metallic/loss of taste, short half life (2-3 hr, others > 12 hr)
Term
-sartan
Definition
ARBs (angiotensin II subtype I receptor blockers)
Term
Candesartan, Olmesartan
Definition
only prodrug ARBs
Term
ACE-I and ARB side effects
Definition
1) dry cough (increase bradykinin)
2)angioedema (vasodilation/serious if involves airways)
3)hyperkalemia (no Na resorbed, K remains in blood)
*all less common with ARBs
Term
ACE-I and ARB contraindications
Definition
1) Bilateral renal artery stenosis i.e. low RPF (unilateral if only one functioning kidney)...start with low dose and monitor serum creatinin
2)hx of angioedema
3)pregnancy (fetal hypotension, malformations, renal failure, death)
Term
Added advantages of -prils (ACE-Is)
Definition
1) cardioprotective (less stroke, MIs)
2) protection against diabetes and nephropathy associated with diabetes
Term
Drugs combined with -prils (ACEIs) and -sartans (ARBs)
Definition
other hypertension drugs (diuretic hydrochlorothiazide which decreases K; calcium channel blockers [with ACEIs] like verapamil which vasodilate arteries)
Term
Aliskiren
Definition
direct renin inhibitor
(like a beta 1 blocker: found in kidneys)
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