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Article ; Online: An Overview of Clinically Imperative and Pharmacodynamically Significant Drug Interactions of Renin-Angiotensin-Aldosterone System (RAAS) Blockers.

Mohamed Pakkir Maideen, Naina / Balasubramanian, Rajkapoor / Muthusamy, Sudha / Nallasamy, Venkateswaramurthy

Current cardiology reviews

2022  Volume 18, Issue 6, Page(s) e110522204611

Abstract: Introduction: Hypertension is a leading cause of cardiovascular disease and chronic kidney disease, resulting in premature death and disability. The Renin-Angiotensin-Aldosterone System (RAAS) blockers, including Angiotensin-Converting Enzyme (ACE) ... ...

Abstract Introduction: Hypertension is a leading cause of cardiovascular disease and chronic kidney disease, resulting in premature death and disability. The Renin-Angiotensin-Aldosterone System (RAAS) blockers, including Angiotensin-Converting Enzyme (ACE) inhibitors or Angiotensin Receptor Blockers (ARBs), are used as first-line antihypertensive therapy to treat hypertensive patients with comorbidities, including diabetes, ischemic heart disease, heart failure, and chronic kidney disease. The use of RAS blockers is associated with the risks, such as hyperkalemia, angioedema, etc. The drugs potentiating them interact pharmacodynamically, resulting in adverse consequences. This review article focuses on the clinically important drug interactions of RAAS blockers.
Materials and methods: The electronic databases, such as Medline/PubMed Central/PubMed, Google Scholar, ScienceDirect, Cochrane Library, Directory of Open Access Journals (DOAJ), Embase, and reference lists were searched to identify relevant articles.
Results: The risk of hyperkalemia may be enhanced potentially in patients receiving a RAS blocker and potassium-sparing diuretics, potassium supplements, trimethoprim, adrenergic betablockers, antifungal agents, calcineurin inhibitors, pentamidine, heparins or an NSAID, concomitantly. The patients taking ACE inhibitors and mTOR inhibitors, DPP4 inhibitors, alteplase, or sacubitril/valsartan concurrently may be at increased risk of developing angioedema.
Conclusion: Clinicians, pharmacists, and other healthcare practitioners should be accountable for medication safety. To avoid adverse implications, prescribers and pharmacists must be aware of the drugs that interact with RAAS blockers.
MeSH term(s) Humans ; Renin-Angiotensin System ; Angiotensin Receptor Antagonists/adverse effects ; Angiotensin-Converting Enzyme Inhibitors/adverse effects ; Hyperkalemia/chemically induced ; Hyperkalemia/drug therapy ; Hypertension/drug therapy ; Drug Interactions ; Renal Insufficiency, Chronic/drug therapy ; Potassium/therapeutic use ; Angioedema/chemically induced ; Angioedema/drug therapy
Chemical Substances sacubitril (17ERJ0MKGI) ; Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme Inhibitors ; Potassium (RWP5GA015D)
Language English
Publishing date 2022-05-06
Publishing country United Arab Emirates
Document type Review ; Journal Article
ISSN 1875-6557
ISSN (online) 1875-6557
DOI 10.2174/1573403X18666220511152330
Database MEDical Literature Analysis and Retrieval System OnLINE

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