Drugs Acting on the Renal System

Question 1

Renin-angiotensin system functions

Answer 1

Controls sodium excretion and body fluid volume

Regulates blood pressure

Question 2

Renin

Answer 2

Aspartyl protease made in kidney (responsible for vasopressor response)

Question 3

Angiotensin

Answer 3

Cofactor to renin that stimulates vasoconstriction

Question 4

Angiotensin II

Answer 4

Constricts branches of artery
Regulates aldosterone secretion
Stimulates release of vasopressin from hypothalamus

Question 5

Aldosterone

Answer 5

Controls reabsorption of sodium into the blood stream
Increases sodium levels in plasma
Increases blood volume and vascular resistance
Stimulates production of endothelin (regulates smooth muscle contraction and blood pressure)

Question 6

Vasopressin

Answer 6

Antidiuretic hormone

Released when dehydrated to conserve water

Question 7

Kinins

Answer 7

Vasodilators formed by proteolytic enzymes circulating in the plasma
Control Na and K balance and arterial blood pressure

Question 8

Angiotensin-converting enzyme (ACE)

Answer 8

Nonspecific peptidyldipeptide hydrolase (converts Ang I to Ang II)
Promotes vasoconstriction

Question 9

ACE inhibitors

Answer 9

Inhibit cleavage of Ang I to Ang II

Question 10

ACE inhibitor prodrugs

Answer 10

Treat mild-to-moderate hypertension

Most have a 2-(S)-aminophenylbutyric acid ethyl ester moiety

Question 11

Angiotensin II receptors

Answer 11

AT1, AT2, AT3, AT4
G-protein coupled receptors
AT1: target for managing specific cardiovascular disease (stimulation results in vasoconstriction, etc.)

Question 12

Main effect of angiotensin antagonists

Answer 12

Block stimulation of AT1 by Ang II

Question 13

Renin inhibitors

Answer 13

Inhibit cleavage of angiotensinogen to angiotensin I

Used to manage cardiovascular disease

Question 14

Aldosterone antagonists

Answer 14

Inhibit sodium resorption in distal tubule of nephron, reducing urinary K+ excretion
Results in a weak diuretic effect and decreases cardiac workload