ACE Inhibitors and ARBs Exam Questions and Answers

ACE Inhibitors and ARBs Exam Questions and Answers Indications - Correct Answer ️️ -- HTN - Prolong survival in HF, Coronary Heart Disease, Acute MI - Slow rate of progression in Chronic renal failure, diabetic neuropathy ACEI mechanism of action - Correct Answer ️️ -Blocks angiotensin-converting enzyme (ACE), which is responsible for converting angiotensin I into angiotensin II. Angiotensin II is vasoconstrictor and stimulates aldosterone release from adrenal glands. - Lowered aldosterone leads to less h2o absorption and Na-K exchange in distal renal tubule. Causes slight increase in serum K. - Inhibit breakdown of vasodilator called bradykinin by blocking kinase II inhibitor (this is likely cause of cough) ARB mechanism of inaction - Correct Answer ️️ -Block angiotensin II from binding to receptors. Do NOT impact bradykinins Which is more active against angiotensin I receptors? - Correct Answer ️️ -ARBs Which is more likely to increase angiotensin levels? - Correct Answer ️️ -ACEI (?) How do ACEIs reduce BPs? - Correct Answer ️️ -Reduce systemic vascular resistance - No effect on cardiac output or heart rate Increased renal perfusion Decreased renal vascular resistance No change in GFR How do ACEIs impact CHF? - Correct Answer ️️ -Decrease preload - Reduce Na/H2O retention via aldosterone secretion reduction Decrease afterload - Act on angiotensin II to decrease systemic vascular resist