1) What is the pharmacodynamics effect of angiotensin-converting enzymes inhibitors (ACEI'S and angiotensin II receptor blockers (ARB'S) in reference to the cardiovascular system?
The pharmacodynamics effect of angiotensin-converting enzymes inhibitors (ACEI'S) and angiotensin II receptor blockers (ARB'S) in reference to the cardiovascular system is based on its overall function of inhibiting the function of angiotensin II and aldosterone hormone production (Woo & Wynne 12). These drugs are purposely used to control high blood pressure, and they tend to act on the renin angiotensin aldosterone system to lower blood pressure. The mechanism of action ARBs is quite different from ACE inhibitors which act by inhibiting the formation of angiotensin II, which increases blood pressure by stimulating smooth muscles and water retention with aldosterone (Anis 19). This helps the body to retain water and sodium ions which decreases blood flow in turn reducing blood pressure in heart arteries. ARBs receptor antagonists on their part functions by blocking type 1 angiotensin II (AT1) receptors situated on bloods vessels and cardiac tissues. Since ARBs do not inhibit the function of ACEIs, its inhibition increases the level of Bradykinin which causes the blood vessels to dilate (Finnegan 886).
2) What medications are the cornerstones of therapy for coronary artery disease (CAD)?
Coronary artery disease (CAD) normally results from accumulation of lipid layers in the wall of cardiac arteries. The medications that are the cornerstone of therapy for this condition includes the anti platelets drug such aspirin. Aspirin functions by blocking and preventing accumulation of lipids on the wall of arteries which cause blood clots (Woo & Wynne 55). Other medications utilized in therapy for CAD includes Antihypertensive drugs which reduces blood pressure, Antilipidemic medications that reduces lipid levels in the blood, and Nitroglycerin which relaxes the heart muscles, Beta-blockers and Angiotensin-converting enzyme (ACE) inhibitors which lowers blood pressure and Anticoagulants also called blood thinners which reduces formation of blood clots in cardiac vessels (Laurence (ed) 76).
3) Explain the reason why a NP would use diuretic (s) as a first-line drug therapy for treatment of heart failure (HF) and hypertension (HTN).
Diuretics would be used as a first line drug therapy for treatment of heart failure and hypertension (HTN) because they exhibit profound effect on decreasing the ECF volume. Diuretic functions by altering the hydrostatic pressure which causes the retention of water and sodium ions which increases extracellular fluid volume and in turn HTN or HF (Anis 87).There are numerous types of diuretics which encourage fluid release, and the common types include the loop diuretics which prevent the re-absorption of sodium ions at the loop of Henle and the Thiazide diuretics which prevents sodium uptake at the distal renal tubules (Finnegan 888).
4) What effects would Fenofibrate and Gemfibrozil medications have on elevated very low density lipoproteins and triglycerides (VLDL). Explain your answer.
Increased very-low-density lipoproteins and elevated triglycerides levels usually cause hyperlipoproteinemia and hyperlipidemia respectively (Woo & Wynne 74).Fenofibrate and Gemfibrozil medications are fibric acid derivatives and their effect would result to lowering of elevated very low density lipoproteins and triglycerides levels in the blood by increasing the activity of lipoprotein lipase, an enzyme which degrades lipids (Finnegan 889).
Anis, Rafik. Role of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in the management of atrial fibrillation. Exp Clin Cardiol. 2009 Spring; 14(1): e1–e7.
Finnegan , Gleason. "Combination ACE inhibitors and angiotensin II receptor blockers for hypertension". The Annals of pharmacotherapy 2003. 37 (6): 886–9.
Laurence , Brunton, ed. "Chapter 30. Renin and Angiotensin - Edwin K. Jackson". Goodman & Gilman’s The Pharmacological Basis of Therapeutics (11 ed.). McGraw-Hill.2006.Print.
Woo, Teri Moser and Wynne, Anita Lee. Pharmacotherapeutics for nurse practitioner
prescribers (3rded.) Philadelphia, PA. F.A. Davis Company.2012.Print.