Renin Angiotensin System and Kinin Drugs Flashcards
Angiotensinogen is converted to Angiotensin I by ____.
Renin
Angiotensin I is converted to Angiotensin II by ___.
ACE (Angiotensin Converting Enzyme)
Angiotensin II is converted to Angiotensin III by _____.
Aminopeptidases
Angiotensin II interacts with which receptors?
AT1 and AT2 Receptors
Angiotensin III interacts with which receptors?
AT1 Receptor
Angiotensin II is converted to Angiotensin-(1-7) by ___.
ACE2
Angiotensin-(1-7) interacts with which receptors?
Mas Receptor
Which RAS pathway is cardioprotective?
ACE2-Angiotensin-(1-7)-Mas pathway
What is the rate limiting factor for the Classic RAS pathway?
Renin
Which RAS pathway is the Classic pathway?
ACE-Angiotensin II-AT1 pathway
Losartan
1) Use
2) Mechanism of Action
3) Adverse effects
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
Valsartan
1) Use
2) Mechanism of Action
3) Adverse effects
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
Candesartan
1) Use
2) Mechanism of Action
3) Adverse effects
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
Irbesartan
1) Use
2) Mechanism of Action
3) Adverse effects
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
Captopril
1) Use
2) Mechanism of Action
3) Adverse effects
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
Enalapril
1) Use
2) Mechanism of Action
3) Adverse effects
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
Lisinopril
1) Use
2) Mechanism of Action
3) Adverse effects
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
Aliskiren
1) Use
2) Mechanism of Action
3) Adverse Effects
1) Essential HTN
2) Renin inhibitor
3) HypoTN, Hyperkalemia, Acute Renal Failure, Angioedema, Dry cough, GI/Allergic symptoms
What are the three causes of vasopressin release?
1) Decreased arterial pressure (baroreceptor)
2) Decreased fluid volume or increased plasma osmolality
3) Pain, nausea, hypoxia, hormones
What are the physiological actions of vasopressin?
1) Antidiuretic effect
2) Direct vasoconstriction
3) Activates vagal nuclei in area postrema –> bradycardia
1) What effects are mediated by V1?
2) How do V1 receptors mediate response?
1) CV effects
2) Couple to Gq receptors –> phospholipase C –> Increased Ca++
1) Where are V2 receptors located?
2) How do V2 receptors mediate response?
1) Collecting ducts
2) Couple to Gs –> adenylyl cyclase –> increased cAMP
Conivaptan
1) Use
2) Mechanism of action
3) Route of administration
1) Treatment of hyponatremia (especially from SIADH)
2) V1/V2 receptor antagonist
3) IV
Tolvaptan
1) Use
2) Mechanism of action
3) Route of administration
1) Treatment of hypervolemic and euvolemic hyponatremia that is resistant to fluid restriction (HF, cirrhosis, SIADH)
2) Selective V2 receptor antagonist
3) Oral
