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Pharmacology 2 > ACE inhibitors and Angiotensin receptor blockers > Flashcards

ACE inhibitors and Angiotensin receptor blockers Flashcards

1
Q

When is the RAAS activated ?

A

When blood pressure/volume falls, in response to salt/water loss and reduced glomerular filtration

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2
Q

What senses the drop in blood volume?

A

Central veins (will be less stretched)

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3
Q

What senses the fall in bp?

A

Baroreceptors in carotid arteries and aortic arch as they will be less stimulated

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4
Q

What will the decrease in baroreceptor stimulation do to sympathetic NS?

A

Increase sympathetic nerve activity

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5
Q

What receptors can noradrenaline work on?

A

B1 receptors

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6
Q

What can the macula dense cells detect?

A

A fall in tubular sodium and they will send a signal to the granular cells to secrete Renin

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7
Q

What do pressure-sensitive granular cells do when responding to localised fall in Renin arterial pressure?

A

Secrete renin

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8
Q

Where are G-protein coupled angiotensin II receptors located?

A

Proximal convoluted tubule

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9
Q

What will angiotensin II attached to G-protein coupled angiotensin II receptors do?

A

Cause an early stimulus of increased sodium reabsorption from the tubular lumen

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10
Q

What is the larger, indirect action of angiotensin II?

A

Angiotensin II acts on angiotensin receptors expressed in the adrenal cortex to stimulate aldosterone secretion

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11
Q

Where will aldosterone move to?

A

Back in the blood to the kidney and will act on receptors in the DCT to promote a larger increase in sodium reabsorption

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12
Q

How is further stimulation of Renin secretion stopped?

A

Negative feedback

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13
Q

What type of receptor does aldosterone (mineralocorticoid) work on ?

A

Intracellular / nuclear receptor

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14
Q

What will the mechanism of action of aldosterone do to the capacity of the DCT

A

It will increase the capacity for the reabsorption of sodium
(There is also a net loss of K+ and H2O)

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15
Q

Free water balance is coupled to ________ balance to maintain __________ _________

A

Sodium

Osmotic pressure

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16
Q

Where is cellular osmolarity detected ?

A

Specialised Receptors in the hypothalamus

17
Q

When specialised receptors in the hypothalamus detect an increase in osmolarity, what do they do?

A

Send a message to posterior pituitary to secrete vasopressin

18
Q

What is vasopressin ?

A

Antidiuretic hormone which travels to the kidney in the blood to exert an action on vasopressin V2 receptors located in the collecting duct .
They are G-protein coupled receptors and are designed to increase the permeability of the collecting duct so that the water can more easily follow sodium by osmosis

19
Q

What does cAMP secrete ?

A

Protein kinase A activation

20
Q

What do the aquaporins now on the membrane do?

A

Make the membrane more permeable and water can pass more readily from the lumen back into the interstitial and the blood.

21
Q

What aquaporins are on the side of the lumen and the interstitial side?

A

Lumen - AQP 2

Interstitium - AQP 3, AQP 4

22
Q

How can Ang II increase glomerular filtration pressure ?

A

Constrict renal efferent arteriole which reduces filtration area

23
Q

What can you tell me about the number of Ang II receptors on the efferent arteriole?

A

They are more abundant than on the affetent arterioles and they mediate vasoconstriction

24
Q

AT1 receptor has a higher agonist potency to which angiotensin?

A

Ang II > Ang III ( active metabolite with one less amino acid)

Note AT2 have similar potency to both

25
Q

Where can you find AT1 receptors ?

A 
Blood vessels
Heart
Kidney
Brain
Lung
Liver
Adrenal
Pituitary glands
26
Q

How could the influence of noradrenaline on renin secretion be tackled pharmacologically?

A

B blockers

27
Q

What ending is given to renin inhibitor drugs?

A

‘Kirens

28
Q

What ending is given to ACE inhibitors?

A

‘Prils

29
Q

What else can ACE metabolise ?

A

Metabolise the Vasodilator peptide bradykinin to an inactive metabolite

30
Q

What ending is given to AT1 receptors antagonist drug?

A

‘Sartans

Pharmacology 2 (6 decks)

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