CAM201 Study Guide - Quiz Guide: Logbook, Cyclic Adenosine Monophosphate, Quinapril
13 Jun 2018
School
Department
Course
Professor
CAM201 Pharmacology Logbook
Vaibhavee Khandelwal
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Drugs Affecting the RAA System
• Conditions favouring use include diabetic nephropathy, post-AMI, heart failure
• Precautions/contraindication: pregnancy, hyperkalaemia
ACE Inhibitors
Captopril, ramipril, quinapril, enalpril, fosinopril, perindopril, lisinopril,
trandolapril
Mechanism of Action
• Inhibit ACE, therefore inhibiting angiotensin II production
• Blocks vasoconstriction, which decreases blood pressure, and preload and
afterload
• Blocks aldosterone release from adrenal cortex, which causes reduced water
and Na+ reabsorption, and decreased K+ release (excretion), reducing blood
volume, which reduced blood pressure (useful in hypertension).
• Reduction in blood volume also decreases cardiac output, decreasing cardiac
workload (useful for heart failure).
• Decreases venous pooling and oedema
AT1 Receptor Blockers
Candesartan, losartan, eprosartan, telmisartan, irbesartan
Mechanism of Action
• Inhibit the action of angiotensin II on AT1 receptors
• Blocks vasoconstriction, which decreases blood pressure
• Blocks aldosterone release from adrenal cortex, which causes reduced water
and Na+ reabsorption, and decreased K+ release → reducing blood volume,
which reduced blood pressure
Clinical Uses
• First line drug for hypertension
• Heart failure
Common Adverse Effects
• Hypotension, dizziness, hyperkalaemia
• Dry cough- ACE inhibitors only, because ACE metabolises bradykinin, so ACE
inhibitors cause bradykinin accumulation, causing dry cough
Favouring Conditions
• Diabetic nephropathy, post-AMI, heart failure
Precautions/Contraindications
• Pregnancy, hyperkalaemia
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Document Summary
Drugs affecting the raa system: conditions favouring use include diabetic nephropathy, post-ami, heart failure, precautions/contraindication: pregnancy, hyperkalaemia. Captopril, ramipril, quinapril, enalpril, fosinopril, perindopril, lisinopril, trandolapril. Clinical uses: first line drug for hypertension, heart failure. Common adverse effects: hypotension, dizziness, hyperkalaemia, dry cough- ace inhibitors only, because ace metabolises bradykinin, so ace inhibitors cause bradykinin accumulation, causing dry cough. Favouring conditions: diabetic nephropathy, post-ami, heart failure. Inhibits aldosterone-induced increase in na+ channels in the luminal membrane and na+/k+ atpase pumps in the basolateral membrane of the collecting tubules. Inhibits the driving force of k+ excretion, so there is decreased k+ excretion- potassium-sparing diuretic. Increases loss of water and na: because aldosterone contributes to the pathophysiology of heart failure, spironolactone improves outcomes. Clinical use: heart failure, to interrupt raas, used in combination with thiazide and loop diuretic to prevent hypokalaemia- hypokalaemia can cause arrhythmias and digoxin toxicity. Cardiac muscle ((cid:574)1) (cid:574)-blocker binds to (cid:574)1 receptor, blocking opposing noradrenaline activity on the receptor.
