Vasoactive peptides (Katzung) Flashcards
Renin Release Blockers
Clonidine
Propranolol
Renin Release Blockers - Effects
Arteriolar dilation
Decreased aldosterone secretion
Increased sodium and water excretion
Renin Release Blockers - Clinical use
Hypertension
Clonidine - MoA
Causing a centrally mediated reduction in renal sympathetic nerve activity, and it may also exert a direct intrarenal action.
Propranolol - MoA
Blocking the intrarenal and extrarenal β receptors involved in the neural control of renin release.
Angiotensin Receptor Antagonists
Losartan Valsartan Eprosartan Irbesartan Candasartan Olmesatran Telmisartan
Angiotensin Receptor Antagonists - MoA
Selective competitive antagonist of angiotensin AT1 receptors
Angiotensin Receptor Antagonists - Effects
Arteriolar dilation
Decreased aldosterone secretion
Increased sodium and water excretion
Angiotensin Receptor Antagonists - Clinical use
Hypertension
Diabetic nephropathy
Heart failure (Alternative when ACE inhibitors are not tolerated)
Combination therapy with an ACE inhibitor
Angiotensin Receptor Antagonists - Adverse effects and Contraindication
Cough (low incidence)
Sprue-like enteropathy
Contraindication: Nondiabetic renal disease and pregnancy
Losartan - Clinical use
Marfan syndrome (By blocking ANG II, which decrease TGF-β, which is usually increased in Marfan syndrome)
Valsartan - Clinical use
Decrease the incidence of diabetes in patients with impaired glucose tolerance.
Angiotensin-Converting Enzyme Inhibitors
Enalapril
Captopril
Angiotensin-Converting Enzyme Inhibitors - MoA
Inhibits conversion of angiotensin I to angiotensin II
They also inhibit the degradation of other substances, including bradykinin, substance P, and enkephalins.
Angiotensin-Converting Enzyme Inhibitors - Effects
Arteriolar dilation
Decreased aldosterone secretion
Increased sodium and water excretion
Angiotensin-Converting Enzyme Inhibitors - Clinical use
Hypertension
Heart failure
Left Ventricular dysfunction
Diabetic nephropathy
Angiotensin-Converting Enzyme Inhibitors - Adverse effects and Contraindications
Cough
Angioedema
Contraindications: Pregnancy because they cause fetal kidney damage.
Renin Inhibitors
Aliskiren
Renin Inhibitors - MoA
Inhibits plasma renin activity
Renin Inhibitors - Effects
Arteriolar dilation
Decreased aldosterone secretion
Increased sodium and water excretion
Renin Inhibitors - Clinical use
Hypertension
Aliskiren - Contraindication
Pregnancy
Kinin Inhibitors
Icatibant
Ecallantide
Cinryze, Berinert
Aprotinin
Kinin Inhibitors - MoA
Selective antagonist of kinin B2 receptors
Kinin Inhibitors - Effects
Blocks effects of kinins on pain, hyperalgesia, and inflammation
Kinin Inhibitors - Clinical use
Hereditary angioedema
Icatibant - Clinical use
Drug-induced angioedema Airway disease Thermal injury Ascites Pancreatitis
Which kinin inhibitor is a plasma kallikrein inhibitor
Ecallantide
Which kinin inhibitor is a kinin synthesis inhibitor
Aprotinin
Vasopressin Agonists
Arginine vasopressin
Terlipressin
Selepressin
Vasopressin Agonists - MoA
Agonist of vasopressin V1 (and V2) receptors
Vasopressin Agonists - Effects
Vasoconstriction
Vasopressin Agonists - Clinical use
Vasodilatory shock
Arginine vasopressin - MoA
Selective V2 antidiuretic analog
Terlipressin - MoA
More selective for V1 receptor but also stimulate V2 receptors
Selepressin - MoA
Selective V1a receptor agonist
Selepressin - Clinical use
Septic shock
Vasopressin Antagonists
Conivaptan
Relcovaptan
Tolvaptan
Vasopressin Antagonists - MoA
Antagonist of vasopressin V1 (and V2) receptors
Vasopressin Antagonists - Effects
Vasodilation