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Questions and Answers
What is the role of angiotensin converting enzyme (ACE) in the angiotensin-renin system?
What is the role of angiotensin converting enzyme (ACE) in the angiotensin-renin system?
Which drug class directly inhibits the action of renin?
Which drug class directly inhibits the action of renin?
What effect does angiotensin II have on blood pressure?
What effect does angiotensin II have on blood pressure?
Which of the following statements is true regarding angiotensin receptor blockers?
Which of the following statements is true regarding angiotensin receptor blockers?
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Captopril and enalapril, which are classes of drugs ending in 'pril', function by:
Captopril and enalapril, which are classes of drugs ending in 'pril', function by:
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What is a common side effect of ACE inhibitors?
What is a common side effect of ACE inhibitors?
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Which statement accurately describes the action of beta blockers like propranolol in the context of the renin-angiotensin system?
Which statement accurately describes the action of beta blockers like propranolol in the context of the renin-angiotensin system?
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Which peptide class is known as potent vasodilators?
Which peptide class is known as potent vasodilators?
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Which of the following kinins are primarily produced in humans?
Which of the following kinins are primarily produced in humans?
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What role do kinin receptors play in the human body?
What role do kinin receptors play in the human body?
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What is the primary action of atrial natriuretic peptide (ANP) in the cardiovascular system?
What is the primary action of atrial natriuretic peptide (ANP) in the cardiovascular system?
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Which of the following drugs acts as a bradykinin receptor antagonist?
Which of the following drugs acts as a bradykinin receptor antagonist?
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What is the primary action of vasopressin in the human body?
What is the primary action of vasopressin in the human body?
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Which of the following statements is true regarding kinin and inflammation?
Which of the following statements is true regarding kinin and inflammation?
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What is the effect of ANP on the renin-angiotensin system?
What is the effect of ANP on the renin-angiotensin system?
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Which of the following groups of drugs inhibit the release of renin from the kidneys?
Which of the following groups of drugs inhibit the release of renin from the kidneys?
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Which of the following drugs is a direct renin inhibitor?
Which of the following drugs is a direct renin inhibitor?
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What do some patients experience as a result of overproduction of renin?
What do some patients experience as a result of overproduction of renin?
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Which of the following is described below:
- enzymes found in the blood and in tissues that form kininogen substrate?
Which of the following is described below:
- enzymes found in the blood and in tissues that form kininogen substrate?
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Which of the following is described below:
-the substrate that kallikrein converts into kinins
-substrate found in plasma and other body fluids?
Which of the following is described below:
-the substrate that kallikrein converts into kinins -substrate found in plasma and other body fluids?
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What are the two major kinins in the human body?
What are the two major kinins in the human body?
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Where are kallidin and bradykinin formed?
Where are kallidin and bradykinin formed?
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What kind of receptors are kinin receptors?
What kind of receptors are kinin receptors?
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What does kinin cause in the cardiovascular system? (Select all that apply)
What does kinin cause in the cardiovascular system? (Select all that apply)
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Match each drug to its MOA
Match each drug to its MOA
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Which of the following is described below:
- increases urine output and increases sodium excretion
- inhibits release of renin and aldosterone
Which of the following is described below:
- increases urine output and increases sodium excretion
- inhibits release of renin and aldosterone
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Which of the following describes carperitide?
Which of the following describes carperitide?
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Which of the following describes nesiritide?
Which of the following describes nesiritide?
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Which of the following is described below:
- blocks renin release
- causes centrally mediated reduction in renal sympathetic nerve activity?
Which of the following is described below:
- blocks renin release
- causes centrally mediated reduction in renal sympathetic nerve activity?
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What are endothelins?
What are endothelins?
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Which of the following are drugs that block endothelin receptors and produce vasodilation?
Which of the following are drugs that block endothelin receptors and produce vasodilation?
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What blocks substance P receptors and is used to treat nausea and vomiting?
What blocks substance P receptors and is used to treat nausea and vomiting?
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What is substance P?
What is substance P?
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Study Notes
Vasoactive Peptides
- Peptides are small proteins, ranging from a few hundred to five amino acids.
- This chapter focuses on bioactive peptides with clinical importance.
Angiotensin-Renin System
- Renin: Released into the bloodstream by the kidneys in response to low blood pressure, also released by many blood pressure lowering drugs.
- Angiotensinogen: Cleaved into Angiotensin I by the kidney enzyme renin.
- Angiotensin I: Further cleaved into Angiotensin II (Angio II) by the enzyme angiotensin-converting enzyme (ACE), found in endothelial cells.
- Angiotensin II (Angio II): A potent vasoconstrictor, more potent than epinephrine. Directly contracts vascular smooth muscle to increase blood pressure. Also stimulates the release of norepinephrine (NE) and aldosterone, which leads to sodium and water retention to elevated blood volume that increasing blood pressure.
- Angiotensin II receptors are G-protein coupled receptors found on many cell surfaces.
Renin Inhibitors
- Aliskiren directly inhibits renin.
- Beta-blockers (e.g., propranolol) inhibit renin release.
ACE Inhibitors
- Inhibit the conversion of Angiotensin I to Angiotensin II (Angio II).
- Examples include captopril and enalapril.
- Not recommended in pregnancy.
- May cause a cough.
Angiotensin Receptor Blockers (ARBs)
- Losartan and valsartan are examples.
- End in "sartan".
- Competitive antagonists at Angio II receptors; block actions preventing vasoconstriction.
- Not recommended in pregnancy; may cause cough which is lower frequency than ACE inhibitors
Kinins
- Potent vasodilators
- Kallikreins are enzymes that form kinins from kininogen.
- Kininogen is a substrate found in plasma and other body fluids.
- Bradykinin and kallidin are the two major kinins in humans.
Vasopressin (ADH)
- Acts on the kidneys to reabsorb water. Increases blood volume and blood pressure
- Tolvaptan and conivaptan are inhibitors of vasopressin actions
Natriuretic Peptides
- Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) lower blood pressure.
- ANP increases urine output and sodium excretion.
- ANP also inhibits renin and aldosterone release.
- BNP agonists (e.g., carperitide, nesiritide) are recombinant forms of the natural peptide.
Other important drugs
- Icatibant: Bradykinin receptor antagonist; given intravenously (commonly for angioedema)
- Vasopressin agonist: (e.g., vasopressin) induces vasoconstriction
- Vasopressin antagonist: (e.g., conivaptan) induces vasodilation
- Kinin inhibitors: (e.g., icatabant) blocks the action of kinins
Other information
- Some drugs are covered in previous chapters
- It is important to remember that not all items in this chapter are equally important clinically, with some drugs with more limited use.
- Many Drugs are listed as important and in bold
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Description
This quiz explores the system of vasoactive peptides, focusing on their clinical relevance. It delves into the angiotensin-renin system, detailing each component involved from renin release to the action of angiotensin II, a key regulator of blood pressure. Test your understanding of these critical physiological processes.
