Angiotensin

Angiotensin Converting Enzyme (ACE) inhibitors lower blood pressure and produce vasodilation by inhibiting ACE – blocking the conversion of angiotensin I to angiotensin II, key mediators of the Renin-Angiotensin-Aldosterone System (RAAS). RAAS is the main mechanism for controlling BP. Angiotensin II is a vasoconstrictor and works by binding to angiotensin I receptors on smooth muscle – these are joined to a Gq protein and the IP3 signal transduction pathway. ACE usually breaks down bradykinin. Bradykinin is a vasodilator. Therefore as ACE is inhibited the breakdown of bradykinin does not occur – leading to the body having higher levels of bradykinin. This mechanism is what gives ACE inhibitors their vasodilation effect. This reduces arterial…

creatinine clearance. So, control resulted in decrease in creatinine clearance. Urine Sodium Clearance 99.5% of sodium in filtrate is typically reabsorbed by the renal tubules (Sherwood, 2015, pp. 505). Sodium is reabsorbed in the proximal tubule and loop of Henle regardless of sodium load. Aldosterone is the main factor when kidneys determine the rate of sodium reabsorption. Aldosterone causes an increase in sodium reabsorption. Aldosterone is usually secreted by the adrenal cortex when…

Renin secretion is stimulated by decreased blood volume, decreased renal perfusion, sodium and water depletion. Subsequently, renin promotes the conversion of angiotensinogen to angiotensin I. Angiotensin I is then converted to angiotensin II through the angiotensin converting enzyme. Due to angiotensin II being a potent vasoconstrictor, it also stimulates aldosterone secretion leading to sodium and water retention. The subsequent renal retention of sodium and water, coupled with an increase in…

silent killer because there are usually no symptoms associated with it. Generally speaking it does not have symptoms however when blood pressure is very high it can cause headaches, dizziness, ringing in the ears, shortness of breath and nausea. One of the causes on systematic level is renal artery stenosis. This is the narrowing of the arteries that transport blood to the kidney. Since the arteries are narrowed they bring in less blood to the kidney. This causes the kidney to sense a lower…

Introduction of Angiotensin-Converting Enzyme Inhibitors LeMone & Burke (2011) stated that in other to accurately discuss angiotensin converting enzyme inhibitors, it is very important to first of all briefly discuss about the three forms of angiotensin. Angiotensin I is produced by the action of renin on a protein called angiotensinogen, which is formed by the liver. Angiotensin I is then transformed into angiotensin II in the blood by the action of angiotensin-converting enzyme ACE.…

According to the American Pharmacists Association, as of late July, Alirocumab, a PCSK9 inhibitor, obtained FDA approval. In addition to diet and aggressive statin therapy, Alirocumab acts as an aid for patients that have clinical atherosclerotic cardiovascular disease or heterozygous familial hypercholesterolemia. These patients are required to lower their cholesterol further. Alirocumab, a monoclonal antibody which is self-administered through subcutaneious injection every two weeks, lowers…

High blood pressure increases mean arterial pressure, which could damage arteries and lead to further complications to organs if left untreated. The renin-angiotensin-aldosterone system (RAAS) regulates blood pressure and is stimulated in response to hypotension. The kidneys release renin into the bloodstream that combines with angiotensinogen, which is released from the liver. This process produces angiotensin I. Angiotensin I combines with Angiotensin-converting enzyme (ACE) to produce…

Lisinopril Overview. Lisinopril is categorized as an angiotensin-converting enzyme (ACE) inhibitor. Lisinopril is most commonly utilized as an antihypertensive or in the treatment of congestive heart failure. This medication also has off-label use in the prophylactic treatment of migraines (Schuh‐Hofer et al., 2007, p. 703). Lisinopril is available as an oral tablet and its bioavailability is approximately 25%. Peak antihypertensive effects of lisinopril are reached at approximately six hours…

calcineurin inhibitors, amphotericin B D. Impairment of renal autoregulatory responses: cyclooxygenase inhibitors (e.g., nonsteroidal anti-inflammatory drugs), angiotensin-converting enzyme inhibitors, or angiotensin II receptor blockers E. Hepatorenal syndrome In cases of hypovolemia, there occurs a fall in mean arterial pressure.This results in the activation of an array of compensatory mechanisms to preserve renalblood flow. This…

increased circulating volumes and therefore increased blood pressures. In addition to the previously mentioned processes the efferent pathway also decreases renal blood flow and to increase perfusion the kidney triggers the afferent pathway that carries impulses to the SNS exacerbating sympathetic over activity and thereby maintaining the high blood pressures. Renin-angiotensin-aldosterone system plays a major in orchestrating the maintenance of normal blood pressures and is activated by dual…