RAMIPRIL

Question 1

Drug class

Answer 1

ACE inhibitor

Question 2

How does it work? (2)

Answer 2

1. block the action of ACE

2. this prevents the conversion of Angiotensin I to Angiotension II

Question 3

What does Angiotensin II do? (2)

Answer 3

• it is a vasoconstrictor

- it stimulates aldosterone secretion

Question 4

What does blocking Angiotensin II do? (2)

Answer 4

• reduces peripheral vascular resistance (after load)

- hence lowering blood pressure

Question 5

How do ACE inhibitors work in CKD? (3)

Answer 5

• dilates the efferent glomerular arteriole
• reducing the intraglomerular pressure
• slowing CKD

Question 6

How do ACE Inhibitors promote sodium and water excretion? (3)

Answer 6

• they prevent angiotensin II production
• Angiotensin II is involved in the production of aldosterone
• reducing the production of aldosterone promotes the excretion of sodium and water

Question 7

How are ACE Inhibitors beneficial for heart failure?

Answer 7

• reduces venous return (preload)

Question 8

Indications (3)

Answer 8

1. heart

• heart failure
• ischaemic heart disease

2. hypertension
3. kidneys

• CKD with proteinuria
• diabetic nephropathy

Question 9

Contra-indications (2)

Answer 9

1. pregnancy and breast feeding
2. kidneys

• AKI
• CKD - low doses
• renal artery stenosis

Question 10

Side effects (4)

Answer 10

1. kidneys
   - renal failure
2. hypotension - 1st dose
3. ion imbalance
   - hyperkaelemia
4. chronic cough
   - bradykinin

Question 11

Interactions (2)

Answer 11

1. NSAIDs

2. potassium elevating drugs

Question 12

Eliminations (2)

Answer 12

1. urine - 60%

2. faeces - 40%