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16 Cards in this Set
- Front
- Back
Types of Renin Angiotensin Inhibitors
|
ACEi
Angiontension Receptor Blockers Direct Renin Inhibitor |
|
ACEi
Included Drugs |
Captopril
Enalapril Lisinopril Ramipril |
|
ACEi
MOA |
Early:
• Inhibit ACE → Angiotensin II ↓ (Later → Angiotensin II escape from ↑Renin ) Late: • Inhibit ACE involved in bradykinin breakdown → Bradykinin ↑ → NO↑, PGE2, PGI2↑ → Vascular relaxation |
|
ACEi
ADME |
• Absorption: Oral
• Distribution: Lipid soluble • Metabolism: • Elimination: Renal |
|
ACEi
Clinical Use |
HTN
CHF Diabetes Renal Disease (usually from diabetes) |
|
ACEi
Adverse Effects |
Common:
• Functional renal insufficiency • Cough (very common) • Hyperkalemia Life threatening: • Angioedema |
|
ACEi
Contraindications and Interactions |
Contraindications -
Pregnancy - AT2 receptors more prominent in fetal life Interactions - • Aspirin - Offsets action by inhibiting prostaglandin synthesis |
|
Angiotension Receptor Blockers
Included Drugs |
Losartan
|
|
Angiotensin Receptor Blockers
MOA |
1. Competitive inhibition of AT1 receptor
→Blocked effects of angiotensin II 2. Residual angiotensin II levels binding AT2 receptor - Opposite effects of AT1 receptor |
|
Angiotensin Receptor Blockers
ADME |
• Absorption: Oral
• Distribution: • Metabolism: • Elimination: Biliary |
|
Angiotensin Receptor Blockers
Clinical Use |
When ACEi can't be used
If patient can't handle cough of ACEi |
|
Angiotensin Receptor Blockers
Adverse Effects |
Hyperkalemia
Cough (4x less likely than with ACEi) |
|
Direct Renin Inhibitor
Included Drugs |
Aliskiren
|
|
Direct Renin Inhibitor
MOA |
Direct inhibition of Renin (rate limiting step)
|
|
Direct Renin Inhibitor
Adverse Effects |
• Renal impairment
• Hypotension • Hyperkalemia • Slight increase in CV events |
|
Direct Renin Inhibitor
Contraindications and Interactions |
Contraindications:
- Diabetes - GFR <60 mL/min |