-pril suffix
How can we tell ACE- inhibitors apart?
-sartan suffix
How can we tell Angiotensin II receptor blockers apart?
aliskiren
What is our renin antagonist?
decrease conversion of Ang I to Ang II; prevents bradykinin breakdown
ACE inhibitor MOA?
angiotensin II
-a potent vasoconstrictor and stimulator of aldosterone secretion
bradykinin
- a vasodilator peptide that stimulates NO and prostaglandins
no reflex tachycardia, enhance diuretic efficacy; less K+ loss
What are benefits of ACEi? (2)
hypotension, renal failure (patients w/ bilateral renal artery stenosis), hyperkalemia, dry cough, angioedema
What are AE's of ACEi?
d,e
Increased Bradykinin leads to what AE's of ACEi?
a) hypotension
b) renal failure
c) hyperkalemia
d) dry cough
e) angioedema
risk of fetal hypotension and renal failure; teratogenic
Why is pregnancy contraindicated with ACEi?
can block bradykinin-induced vasodilation
Why are NSAIDs contraindicated with ACEi?
potassium supplements & potassium diuretics; hyperkalemia
What must be avoided when using ACEi? Why?
competitively antagonize AngII binding receptors (AT1); no effect on bradykinin
ARBs MOA?
when they can't tolerate an ACEi
When do we start a patient on an ARB?
ARBs; ACEi
_______ have less coughing and edema than ______.
b
Which is more selective?
a) ACEi
b) ARBs
competitive inhibitor of renin; decreases water retention and vasoconstriction
Aliskiren MOA?
stroke, renal complications, hyperkalemia, hypotension
Aliskiren AE's? (4)
diabetics; adverse cardiovascular events
Who can not tolerate a combination of Aliskiren + ACEi or ARB? Why?