Renin Angiotensin System and Kinin Drugs

Question 1

Angiotensinogen is converted to Angiotensin I by ____.

Answer 1

Renin

Question 2

Angiotensin I is converted to Angiotensin II by ___.

Answer 2

ACE (Angiotensin Converting Enzyme)

Question 3

Angiotensin II is converted to Angiotensin III by _____.

Answer 3

Aminopeptidases

Question 4

Angiotensin II interacts with which receptors?

Answer 4

AT1 and AT2 Receptors

Question 5

Angiotensin III interacts with which receptors?

Answer 5

AT1 Receptor

Question 6

Angiotensin II is converted to Angiotensin-(1-7) by ___.

Answer 6

ACE2

Question 7

Angiotensin-(1-7) interacts with which receptors?

Answer 7

Mas Receptor

Question 8

Which RAS pathway is cardioprotective?

Answer 8

ACE2-Angiotensin-(1-7)-Mas pathway

Question 9

What is the rate limiting factor for the Classic RAS pathway?

Answer 9

Renin

Question 10

Which RAS pathway is the Classic pathway?

Answer 10

ACE-Angiotensin II-AT1 pathway

Question 11

Losartan

1) Use
2) Mechanism of Action
3) Adverse effects

Answer 11

1) HTN, Heart Failure
2) Angiotensin Receptor Blocker(ARB)-competitive antagonists of AT1 receptors while activating AT2 Receptors and increased production of Ang-(1-7)
3) HypoTN, Hyperkalemia, Acute Renal Failure

Question 12

Valsartan

1) Use
2) Mechanism of Action
3) Adverse effects

Answer 12

1) HTN, Heart Failure
2) Angiotensin Receptor Blocker(ARB)-competitive antagonists of AT1 receptors while activating AT2 Receptors and increased production of Ang-(1-7)
3) HypoTN, Hyperkalemia, Acute Renal Failure

Question 13

Candesartan

1) Use
2) Mechanism of Action
3) Adverse effects

Answer 13

1) HTN, Heart Failure
2) Angiotensin Receptor Blocker(ARB)-competitive antagonists of AT1 receptors while activating AT2 Receptors and increased production of Ang-(1-7)
3) HypoTN, Hyperkalemia, Acute Renal Failure

Question 14

Irbesartan

1) Use
2) Mechanism of Action
3) Adverse effects

Answer 14

1) HTN, Heart Failure
2) Angiotensin Receptor Blocker(ARB)-competitive antagonists of AT1 receptors while activating AT2 Receptors and increased production of Ang-(1-7)
3) HypoTN, Hyperkalemia, Acute Renal Failure

Question 15

Captopril

1) Use
2) Mechanism of Action
3) Adverse effects

Answer 15

1) Essential HTN, Heart Failure, MI
2) Angiotensin Converting Enzyme Inhibitor (ACEIs)-inhibits the conversion of Angiotensin I to Angiotensin II and inhibits the breakdown of Ang-(1-7)
3) Angioedema (d/t bradykinin), Dry cough

Question 16

Enalapril

1) Use
2) Mechanism of Action
3) Adverse effects

Answer 16

1) Essential HTN, Heart Failure, MI
2) Angiotensin Converting Enzyme Inhibitor (ACEIs)-inhibits the conversion of Angiotensin I to Angiotensin II and inhibits the breakdown of Ang-(1-7)
3) Angioedema (d/t bradykinin), Dry cough

Question 17

Lisinopril

1) Use
2) Mechanism of Action
3) Adverse effects

Answer 17

1) Essential HTN, Heart Failure, MI
2) Angiotensin Converting Enzyme Inhibitor (ACEIs)-inhibits the conversion of Angiotensin I to Angiotensin II and inhibits the breakdown of Ang-(1-7)
3) Angioedema (d/t bradykinin), Dry cough

Question 18

Aliskiren

1) Use
2) Mechanism of Action
3) Adverse Effects

Answer 18

1) Essential HTN
2) Renin inhibitor
3) HypoTN, Hyperkalemia, Acute Renal Failure, Angioedema, Dry cough, GI/Allergic symptoms

Question 19

What are the three causes of vasopressin release?

Answer 19

1) Decreased arterial pressure (baroreceptor)
2) Decreased fluid volume or increased plasma osmolality
3) Pain, nausea, hypoxia, hormones

Question 20

What are the physiological actions of vasopressin?

Answer 20

1) Antidiuretic effect
2) Direct vasoconstriction
3) Activates vagal nuclei in area postrema –> bradycardia

Question 21

1) What effects are mediated by V1?

2) How do V1 receptors mediate response?

Answer 21

1) CV effects

2) Couple to Gq receptors –> phospholipase C –> Increased Ca++

Question 22

1) Where are V2 receptors located?

2) How do V2 receptors mediate response?

Answer 22

1) Collecting ducts

2) Couple to Gs –> adenylyl cyclase –> increased cAMP

Question 23

Conivaptan

1) Use
2) Mechanism of action
3) Route of administration

Answer 23

1) Treatment of hyponatremia (especially from SIADH)
2) V1/V2 receptor antagonist
3) IV

Question 24

Tolvaptan

1) Use
2) Mechanism of action
3) Route of administration

Answer 24

1) Treatment of hypervolemic and euvolemic hyponatremia that is resistant to fluid restriction (HF, cirrhosis, SIADH)
2) Selective V2 receptor antagonist
3) Oral