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- decreased cardiac output in blood volume
- stimulate the kidney to release renin
- enzyme into circulation then the
- angiotensinogen protein produced by the
- liver and released into circulation is
- degraded by rena and enzyme in to
- angiotensin one
- the angiotensin-converting enzyme is
- produced by the lung and released into
- circulation to degrade the angiotensin
- one into angiotensin ii angiotensin ii
- has many biological effects it directly
- induces vasoconstriction
- it stimulates the secretion of
- aldosterone hormone from the adrenal
- glands aldosterone in turn stimulates
- the nephrons to reabsorb sodium and
- water from renal tubules back to the
- circulation in exchange with potassium
- ions that will be excreted with urine
- both vasoconstriction and increased
- blood volume will increase the blood
- pressure
- now I will briefly illustrate the Rena
- and angiotensin system inhibitors such
- as angiotensin converting enzyme
- inhibitors angiotensin receptor blockers
- andreen and inhibitors
- angiotensin-converting enzyme inhibitors
- abbreviated as AC e I will interfere
- with angiotensin converting enzyme
- activities and inhibit the production of
- angiotensin ii decreased angiotensin ii
- levels will induce vasodilation
- similarly the aldosterone secretion will
- be suppressed and as a result more
- sodium and water will be excreted into
- the urine
- both vasodilation and decreased blood
- volume will result in decreasing blood
- pressure
- ACE inhibitors drugs include captopril
- enalopril and ramipril and as you can
- see all the drugs in this group are
- ended with suffix PR IL naturally
- angiotensin converting enzyme produced
- and secreted by the lung degrades the
- bratty Keenen molecules into an active
- metabolites
- the ACE inhibitors interfere with this
- degradation process and as a result
- increases the bratty Keenan
- concentration bratty Keenan itself can
- induce vasodilation which is good
- biological effects that enhance the
- antihypertensive effect of ACE
- inhibitors
- however elevated levels of bratty Keenan
- will induce bronchoconstriction and
- annoying cough indeed this is the most
- common side effects of ACE inhibitors
- angioedema is a rare side effects
- induced by elevated bratty Keenan levels
- the important question for scientists
- was how can we inhibit the Rena and
- angiotensin system without interfering
- with angiotensin converting enzyme and
- luckily they reached a solution
- the angiotensin receptor blockers group
- abbreviated as armed will inhibit the
- binding of angiotensin 2 to their
- cellular receptors
- thus angiotensin 2 will not be able to
- induce vasoconstriction and instead
- vasodilation is induced
- similarly angiotensin 2 will not be able
- to stimulate the secretion of
- aldosterone from adrenal cortex as a
- result more sodium and water will be
- excreted from circulation into the urine
- and as expected both vasodilation and
- decreased blood volume will decrease the
- blood pressure
- and the most import point is that
- angiotensin converting enzyme will not
- be inhibited and will keep working as
- usual and bratty Keenan levels will not
- increased so cough is not a common side
- effect of ARB drug names in this group
- include val certain losartan until miss
- erdan as you notice all the drugs and
- with suffix Arden in chronological order
- the oldest generation is ace inhibitors
- then angiotensin receptor blockers and
- finally the new generation greenin
- inhibitors such as Alice Chiron
- greenin inhibitors interfere with action
- of renin enzymes
- thus inhibit the production of
- angiotensin 1 and angiotensin 2 and as
- expected decreased angiotensin ii levels
- will leads to vasodilation
- and suppression of aldosterone secretion
- which results in increased sodium and
- water excretion
- and as previous drug groups vasodilation
- and decreased blood volume will decrease
- the elevated blood pressure
- like angiotensin receptor blockers
- greenin inhibitor does not interfere
- with angiotensin converting enzyme
- activities therefore cough is not a
- common side effect of renin inhibitor
- there is only single drug in this group
- which is Alice Chiron
- with my best wishes dr. jihad Hamid
-
decreased cardiac output in blood volume
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