Hypertension medications that affect the RAAS system - Pharmacology - Cardiovascular | @LevelUpRN

Summary

This educational video script focuses on cardiovascular medications, particularly those for hypertension and angina. It reviews the renin-angiotensin-aldosterone system (RAAS) and introduces various classes of medications that target different parts of this system. Key drugs discussed include aliskiren, ACE inhibitors like captopril and lisinopril, angiotensin II receptor blockers like losartan and valsartan, and aldosterone antagonists like eplerenone. The script highlights their mechanisms of action, side effects, and the importance of blood pressure monitoring during therapy.

Takeaways

• 💊 The video discusses cardiovascular medications, focusing on those used for hypertension and angina.
• 🔍 A review of the Renin-Angiotensin-Aldosterone System (RAAS) is provided as a foundation for understanding the medications.
• 👉 Aliskiren, a direct renin inhibitor, is highlighted for its role in treating hypertension by inhibiting the conversion of angiotensinogen to angiotensin I.
• 🚫 Aliskiren carries a black box warning due to fetal toxicity and can cause hypotension, angioedema, and GI upset.
• 🌟 ACE inhibitors, such as captopril and lisinopril, are used for hypertension, heart failure, myocardial infarction, and diabetic nephropathy.
• 📉 ACE inhibitors work by blocking the conversion of angiotensin I to angiotensin II, leading to vasodilation.
• 🤒 Key side effects of ACE inhibitors include hypotension, angioedema, cough, and elevated potassium levels.
• 💧 Angiotensin II receptor blockers, like losartan and valsartan, are used to treat hypertension and diabetic nephropathy by blocking angiotensin II effects.
• 😵 Side effects of angiotensin II receptor blockers include hypotension, dizziness, and GI upset, with a black box warning for fetal toxicity.
• 🛡️ Aldosterone antagonists, such as eplerenone, are used for hypertension and heart failure post-MI by blocking mineral corticoid receptors.

Q & A

What is the primary function of the renin-angiotensin-aldosterone system (RAAS)?

The RAAS system is involved in regulating blood pressure and fluid balance in the body. Renin activates angiotensinogen into angiotensin I, which is then converted into angiotensin II by ACE. Angiotensin II causes vasoconstriction, promotes the reabsorption of water and sodium at the kidneys, and stimulates the release of aldosterone, which further enhances sodium and water reabsorption.

How does the medication aliskiren work within the RAAS system?

Aliskiren is a direct renin inhibitor that acts by inhibiting renin, preventing the conversion of angiotensinogen into angiotensin I. This action at the top of the RAAS system helps to lower blood pressure.

What are the potential side effects of aliskiren?

Side effects of aliskiren include hypotension, angioedema, and gastrointestinal upset. It also carries a black box warning due to fetal toxicity.

Which class of medications are ACE inhibitors, and how do they work?

ACE inhibitors, such as captopril and lisinopril, work by blocking the conversion of angiotensin I into angiotensin II, leading to vasodilation and a reduction in blood pressure.

What are the key side effects associated with ACE inhibitors?

Key side effects of ACE inhibitors include hypotension, angioedema, cough, and elevated potassium levels. They also carry a black box warning for fetal toxicity.

How can one remember which medications are ACE inhibitors?

ACE inhibitors often end in '-pril', which can be remembered with the mnemonic that drawing an 'ace' in cards gives you a 'thrill'.

What is the role of angiotensin II receptor blockers in hypertension treatment?

Angiotensin II receptor blockers, such as losartan and valsartan, treat hypertension by blocking the effects of angiotensin II, resulting in vasodilation.

What are the common side effects of angiotensin II receptor blockers?

Common side effects include hypotension, dizziness, and gastrointestinal upset. These medications also carry a black box warning for fetal toxicity.

How can one remember the side effects of angiotensin II receptor blockers?

The side effects can be remembered as they relate to the mnemonic 'Satan', which is associated with the '-sartan' ending of these medications, and include hypotension, dizziness, and GI upset.

What is the function of eplerenone, and how does it work within the RAAS system?

Eplerenone is an aldosterone antagonist used for hypertension and heart failure after a myocardial infarction. It blocks mineral corticoid receptors, inhibiting the effects of aldosterone and reducing sodium and water reabsorption.

What are the side effects of eplerenone, and why is potassium level monitoring important?

Side effects of eplerenone include hyperkalemia and dizziness. Monitoring potassium levels is crucial due to the risk of elevated potassium, a significant side effect of this medication.

What advice is given to patients taking medications that can cause hypotension?

Patients should be advised to change positions slowly to avoid symptoms of hypotension, such as dizziness upon standing quickly.