CH. 47 RAAS Pharm 2

hey gals lol

Angiotensin I

An inactive precursor that is converted to angiotensin II by angiotensin-converting enzyme (ACE).

Spironolactone 

blocks aldosterone receptors and binds with receptors for other steroid hormones.

Angiotensin II

A highly active hormone that causes vasoconstriction and stimulates the release of aldosterone.

Actions of Angiotensin II

vasoconstriction, release of aldosterone, and alteration of cardiac and vascular structure.

Aldosterone

A hormone that regulates blood volume and blood pressure and has pathologic cardiovascular effects.

What class is Eplerenone [inspra]

Aldosterone Antagonist 

Renin

An enzyme that catalyzes the formation of angiotensin I from angiotensinogen.

Bradykinin

A peptide involved in inflammatory responses, which causes vasodilation and can lead to swelling and pain.

Effects of reduced Angiotensin II

decreased vasodilation, blood volume, cardiac/vascular remodeling, potassium retention, and fetal injury.

ACE inhibitors

Medications that reduce levels of angiotensin II and increase levels of bradykinin.

Therapeutic uses for ACE inhibitors

Hypertension, heart failure, myocardial infarction, diabetic nephropathy, and prevention of cardiovascular events.

Adverse effects of ACE inhibitors

Can include first-dose hypotension, cough, angioedema, fetal injury, and hyperkalemia.

Angiotensin II receptor blockers (ARBs)

Block access of angiotensin II, causing dilation of arterioles and veins, and preventing pathologic changes.

What class is Aliskiren [tekturna]

Direct renin inhibitor

Therapeutic uses for Angiotensin II receptor blockers (ARBs)

hypertension, heart failure, MI, diabetic neuropathy, Patient unable to tolerate ACE inhibitors

Adverse effects of Angiotensin II receptor blockers (ARBs)

fetal injury, Angioedema, renal failure

Differences between ACE inhibitors and ARBs

ACE inhibitors increase bradykinin levels and cause cough, while ARBs do not increase bradykinin.

Direct Renin inhibitors

Medications that bind tightly with renin, preventing the formation of angiotensin II.

Adverse effects of direct renin inhibitors

cough, fetal injury, Gi effects, hyperkalemia, angioedema, death

Aldosterone antagonists

Medications that selectively block aldosterone receptors, used for hypertension and heart failure.

Side effects of Aldosterone antagonists

Includes hyperkalemia and possible hormonal side effects such as gynecomastia and menstrual irregularities.

Interactions with Aldosterone antagonists

inhibitors of cyp3a4, drugs that raise potassium levels, and lithium 

gynecomastia

is the enlargement of breast tissue in males (Man boob)

hirsutism

excessive hair growth in women (lady beard)