Here’s a review of the Renin-Angiotensin-Aldosterone system (RAAS)



This is a very common pathway that clinicians should definitely know. The end point is aldosterone which does a lot of different things not listed here, but the main takeaway is that the RAAS system ends with excreting potassium while retaining sodium, which causes increased blood pressure. The 4 RAAS inhibiting drug classes (Aliskiren, ACEI, ARB, and Aldosterone Antagonists), all block some part of this pathway, ending with the reversed result of excreting sodium while retaining potassium. This decreases blood pressure because of the sodium excretion, BUT will increase potassium retention, which is why potassium is an important monitoring parameter to avoid harmful hyperkalemia. An easy way to remember this is spironolactone is categorized as an Aldosterone antagonist AND a potassium-sparing diuretic, which means it increases potassium, just like all of the RAAS inhibiting drugs.



Jarred Prudencio, PharmD - https://www.instagram.com/ambcarerx



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