Pharmacology II Final Exam 2023 with 100% correct answers

Angiotensin-Converting Enzyme Inhibitors MOA correct answersACE inhibitors produce their beneficial effects and adverse effects by (1) reducing levels of angiotensin II (through inhibition of ACE) and (2) increasing levels of bradykinin (through inhibition of kinase II). By reducing levels of angiotensin II, ACE inhibitors can dilate blood vessels (primarily arterioles and to a lesser extent veins), reduce blood volume (through effects on the kidney), and, importantly, prevent or reverse pathologic changes in the heart and blood vessels mediated by angiotensin II and aldosterone. -Suffix: pril -Captopril is prototype ACE inhibitors pharmacokinetics correct answers• Nearly all ACE inhibitors are administered orally. The only exception is enalaprilat (the active form of enalapril), which is given IV. • Except for captopril and moexipril, all oral ACE inhibitors can be administered with food. • With the exception of captopril, all ACE inhibitors have prolonged half-lives, and hence can be administered just once or twice a day. Captopril is administered 2 or 3 times a day. • With the exception of lisinopril, all ACE inhibitors are prodrugs that must undergo conversion to their active form in the small intestine and liver. Lisinopril is active as given. • All ACE inhibitors are excreted by the kidneys. As a result, nearly all can accumulate to dangerous levels in patients with kidney disease, and hence dosages must be reduced in these patients. Only one agent—fosinopril—does not require a dosage reduction. ACE inhibitors therapeutic uses correct answersWhen the ACE inhibitors were introduced, their only indication was hypertension. Today, they are also used for heart failure, acute MI, left ventricular (LV) dysfunction, and diabetic and nondiabetic nephropathy. In addition, they can help prevent MI, stroke, and death in patients at high risk for cardiovascular events. It should be noted that no single ACE inhibitor is approved for all of these conditions. However, given that all ACE inhibitors are very similar, it seems likely that all may produce similar benefits. ACE inhibitors adverse effects correct answers"prils make you ill" ACE inhibitors are generally well tolerated. Some adverse effects (e.g., first-dose hypotension, hyperkalemia) are due to a reduction in angiotensin II, whereas others (cough, angioedema) are due to elevation of bradykinin.