ACEI and ARB's

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Author:
jaime.davenport
ID:
240325
Filename:
ACEI and ARB's
Updated:
2013-10-13 17:18:22
Tags:
ACEI ARB
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Description:
Pharm Midterm Fall 2013
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  1. ACEI end in
    -pril
  2. ARB drugs end in
    -sartan
  3. Indications for ACEI and ARB
    • HTN
    • HF-prolong survival- should be given ACEI trial)
    • CAD-prolong survival
    • MI- prolong survival
    • LV dysfunction- prolongs survival rate( should be given ACEI trial)
    • Diabetic neuropathy
    • Hypertensive crisis
  4. ACEI MOA
    block the conversion of angiotensin I to angiotensin II (this is very important)
  5. Positive effects of ACEI on cardiac function
    • reduces preload and afterload
    • increases CI and EF=increased CO (increased blood to coronary arteries, and increased nourishment to the heart)
  6. ACE increase blood flow to which vital organs
    • heart
    • brain
    • kidneys (without reflex tachycardia)
  7. ACEI  and ARB's are ______ protective
    renal
  8. ARB's MOA
    block the effect of angiotensin II by blocking angiotensin II to its receptor site.
  9. Unlike ACEI, ARB's do not increase the level of  ________?
    bradykinin

    ACEI increase the level of bradykinin, and ARB's do not.
  10. Receptor affinity in ARB drugs
    candesartan> ibesartan> eprosartan> telmisartan> valsartan> losartan

    Does not always mean that candesartan should be started first, it has a lot to do with what the insurance company will pay for.
  11. Dosage of ACEI and ARB's
    • vary with drug
    • usually given every day or twice per day

    START LOW AND GO SLOW!!
  12. ADR of ACEI and ARBs
    Very rare and very few

    Rare- rash, diaphoresis, flushing, photosensitivity, and puritis, abdominal pain, nausea, diarrhea, constipation, asthma, bronchospasm

    • ANGIOEDEMA
    • COUGH- RARE WITH ARBS
  13. Common ADR of ACEI
    Cough and angioedema (potentially life threatening and is common with ACEI, greater than 50% of occurrences will occur within one week of therapy)
  14. Do not use ______ in patient with renal artery stenosis because blood flow is diminished
    ACEI- especially bilateral artery stenosis

    ACEI are good for kidneys but not if they have renal stenosis
  15. ACEI and ARBs are not as beneficial in _______ population
    African American

    Use thiazide diuretic, and CCB
  16. ACEI should be given to all patients with symptomatic or asymptomatic ________?
    heart failure
  17. Monitoring ACEI and ARBs
    All patients should have a periodic ______, ______, _______, and _________.
    • urinalysis, BUN, creatinine, and serum electrolytes.
    • Once dose is stable check creatinine and potassium after 2-4 weeks
    • Then if patient without risk factors can check them every 3-6 months.
  18. ACEI and ARB pregnancy category
    C and D

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