1. True or False?

    Angiotensin converting enzyme is a cytoplasmic enzyme because angiotensinogen is a steroid hormone.

    ACE faces the vasculature lumen because angiotensinogen is a peptide hormone.
  2. To what class of drugs does lisinopril belong?
  3. What are the indications for lisinopril?
    HTN, CHF.
  4. What is the target MOA for lisinopril?
    Competes for angiotensin I for its binding site on the angiotensin converting enzyme. This prevents the formation of angiotensin I and also some aldosterone secretion.
  5. Relatively how strong is the affinity of lisinopril for ACE?
    Ki is in the nanometer range.
  6. True or False?

    After some time, doses of lisinopril may need to be increased to maintain efficacy.

    As angiotensin I builds up in the body, increased doses of lisinopril may be needed to maintain its efficacy.
  7. True or False?

    ACE is confined mostly to the body's vasculature.

    It is distributed throughout the whole body, with its highest activity in the vasculature.
  8. What is the function of kininase II?
    Kininase II is ACE, and aside from converting Angiotensin I to Angiotensin II, it also brakes bradykinin down to inactive products.
  9. True or false?

    ACEIs potentiate the action of bradykinin.
  10. When on lisinopril, what will happen to levels of the following?

    Bradykinin, renin, aldosterone
    • Increase: bradykinin, renin
    • Decrease: aldosterone

    *Renin increases as the body tries to compensate for what it percieves as a low BP
  11. What are some adverse effects associated with lisinopril?
    • Orthostatic hypotension
    • Hypotension
    • Cough (5-20%)
    • Hyperkalemia (as aldosterone levels decrease)
    • Angioedema
  12. How might lisinopril effect a pregnant woman or her fetus?
    Lisinopril can cross the placenta and cause hypotension in a fetus.
  13. True or False?

    The major enzymes of the renin-angiotensin system may be bypassed in certain circumstances.
    True. (see bottom figure of lisinopril page)
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