Saturday, April 11, 2015

Study group discussion: Diabetes and ACE inhibitors

Question: Which of the following drug is best for reducing proteinuria in a diabetic patient?
A. Metoprolol
B. Perindopril
C. Chlorthiazide
D. Clonidine

Answer: ACE inhibitors!
B. Perindopril

ACE inhibitors ends with -pril.
Mnemonic: I will ACE my aPRIL test.

Could someone explain this?
They have a mortality benefit. Diabetic patients on ace inhibitors are less likely to develop nephropathy in the future.

Blockade of the renin-angiotensin system in type 2 diabetic patients with diabetic nephropathy reduces uMCP-1 levels and improves renal function.
Because MCP-1 induces monocyte immigration and differentiation to macrophages, which augment extracellular matrix production and tubulointerstitial fibrosis, pharmacological reduction of angiotensin II may also exert its beneficial effects in diabetic nephropathy by downregulation of renal MCP-1.

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