Question 3 Flashcards
SNS System
- SNS and PNS control functions such as blood pressure and heart rate
- activated when the body is stressed or in danger, aka fight or flight.
- if activated, it can lead to vasoconstriction, increase heart rate and cardiac output, and excretion of renin from the kidneys which activates the kidneys
RAAS System
- renin activates hormones of the RAAS, which raises BP by constricting blood vessels and increasing the reabsorption of salt & water.
- works when liver makes angiotensiogen (enzyme)
- renin cleaves to angiotensinogen creating angiotensin 1
- angiotensin then converts from ANG 1 to ANG 2
- Ang 2 attaches to receptors on arterioles to induce vasoconstriction. Which increases BP, peripheral resistance and after load.
Over activation of SNS RAAS can lead to an increase in
- peripheral resistance
- heart rate
- BP
- blood volume
Ventricular remodeling
- happens after changes occur from SNS and RAAS systems.
- causes heart to activate natriuretic peptide system
Atrial natriuretic peptides (ANP) and brain type natriuretic peptides (BNP)
- both are secreted from the stretch in cardiac atria & ventricles.
- both act against the SNS and RAAS
- happens when BNP opposes actions of ANG 2. Which decreases bp, blood vol, and vasoconstriction.
- takes stress off heart
BNP and NTproBNP
- positive system but are indicative of HD
- NTpro BNP is not degraded by Entresto.
- both often used as a marker for diagnosing HF.
Neprilysin
- body creates it to keep the cycle going
- degrades BNP by stopping its positive effects on the RAAS system
Neprilysin
- body creates it to keep the cycle going
- degrades BNP by stopping its positive effects on the RAAS system
Neprilysin
- body creates it to keep the cycle going
- degrades BNP by stopping its positive effects on the RAAS system
Neprilysin
- body creates it to keep the cycle going
- degrades BNP by stopping its positive effects on the RAAS system
Neprilysin
- body creates it to keep the cycle going
- degrades BNP by stopping its positive effects on the RAAS system
Neprilysin
- body creates it to keep the cycle going
- degrades BNP by stopping its positive effects on the RAAS system
Neprilysin
- body creates it to keep the cycle going
- degrades BNP by stopping its positive effects on the RAAS system
Entresto
- not only targets RAAS with its ARB component, but it’s a neprilysin inhibitor. meaning it blocks the neprilysin from degrading BNP
- the increased natural effect of BNP will continute to control ANG II.
- Valsartin will assist to help also control ANG II
- so its a double whammy
