Direct Renin Inhibitors (Nursing)

00:01 Now how about direct renin inhibitors? Stop for a minute and think back to that flow chart, which part of the flowchart - beginning, middle, or end - do direct inhibitors get involved? Obviously, it’s the first, right, because the RAAS start with renin.

00:19 So if we can inhibit renin, we're gonna have a huge impact on the patient’s blood pressure.

00:25 If you inhibit renin, you suppress the RAAS from step one.

00:30 So what are the adverse effects? There’s our friend the red box to talk to us.

00:34 They have less cough and angioedema than ACE inhibitors but they may still develop it.

00:39 They should not be used in pregnancy either, so shouldn't use ACE inhibitors, you shouldn't use ARBs, and you shouldn’t use DRIs in pregnancy.

00:51 Hyperkalemia maybe a problem especially if you use it with a ACE inhibitors, so watch that carefully.

00:57 That’s not a great combination.

00:59 Now that brings up a really good point, that patients are often not just on one blood pressure medication.

01:05 I know at one point, when my weight was not under control, I was on five different kinds of blood pressure medications - so thankfully I don’t have to be on those now, but over the history you're gonna see patients all the time that are on multiple medications, maybe even more than I was on.

01:24 So keep that in mind, we use medications that come out with different mechanisms and that’s how we used to treat blood pressure that is really hard to control.

01:32 But I promise you, I'm a living example that lifestyle really does impact your level of hypertension.

01:39 So if you can maintain a healthy weight for your body and cardiovascular fitness, you're gonna really help your patients control their blood pressure.