Agents "" Flashcards
Sodium pump will produce ______________
adenosine
catecholamines will release renin
nitric oxide will release renin
angiotensin II will decrease release of renin through negative feedback
if we have too much volume blood vessels feel the pressure
Adenosine decreases renin
Renin-Angiotensin
Angiotensin Receptors (AT)
AT1- vascular smooth muscle, Gq → smooth muscle
_____________
contraction
AT2 (Angiotensin II Type 2)
_________by bradykinin B2 receptor-NO-cGMP pathway
Present at high density during ____________
An undetectable level after birth
(low levels in the heart, adrenal gland, kidney, brain, and reproductive tissues)
Upregulated in HF and __________
vasodilation
fetal development
myocardial infarction
INHIBITION OF THE RENIN ANGIOTENSIN SYSTEM
____________ (Angiotensin conversing enzyme Inhibitors) Inhibit the conversion of ANG I to ANG II
__________ (Angiotensin Receptor Blockers)
Block angiotensin AT1 receptors
DRIs (Direct Renin Inhibitors)
ACE inhibitors
ARBs
Angiotensinogen is converted to angiotensin I by renin.
Aliskiren can inhibit renin
if we inhibit ACE(angiotensin-converting enzyme) with ACE inhibitors it involves inactivation of ________________
bradykinin
Angiotensin II is the active form which leads to an increase in _________and an increase in ____________ and increase in blood pressure
blood volume
vasoconstriction
Kininogen–>__________(active)—> increase in NO, PGI2, and vasodilation–> ________blood pressure
Bradykinin (active)
decrease in blood pressure
ACE inhibitors blocks ACE from converting Angiotensin I to Angiotensin II and __________ blood pressure
decrease
Too much bradykinin in the body will cause person to develop dry _________
cough
ACE inhibitors (ACE-I)
Inhibition of ACE prevents Angiotensin II formation
Increase in natriuresis (by aldosterone) Na OUT
K +sparing effect (by aldosterone)K IN
ACE inhibitors (~pril) – Examples
Benazepril (_________)
Captopril
Enalapril (_________), Enalaprilat (Vasotec IV)
Lisinopril (Prinivil, Zestril)
Lotensin
Vasotec
Enalaprilat is the active form prodrug activates after being metabolized
ACE inhibitors (~pril)
Uses
_______________
Decrease in systemic vascular resistance
Used in combination with Ca2+ channel
blocker, beta blocker, thiazide diuretic
___________ infarction (MI)
hypertension
myocardial infarction
ACE inhibitors - ADRs (adverse drug reactions)
____________ (Bradykinin accumulation)
Teratogenic effect
Hyperkalemia
_____________ (swelling of tongue, lips)
Acute renal failure
Dry cough
angioedema
What happens if the Renin-Angiotensin System is blocked in patients with narrowing in renal arteries
(renal artery stenosis)?
It decreases _____________ (GFR).
→ Potential for acute renal failure
↓Glomerular capillary hydrostatic pressure
decreases glomerular filtration rate
ACE inhibitors
Careful monitoring required
____________: decrease rate of absorption
NSAIDs (hyperkalemia)
___________diuretics
Hypovolemia : patients with CHF
Antacids
K+ sparing diuretics
