Friday, 24 April 2015

ACE AND ARBS

Angiotensin inhibitors are recommended when preferred first line agents(diuretics and beta blockers) are  contra indicated or ineffective.
 These are two types.
    a) ACE inhibitors
    b) ARBs

Renin is synthesized and stored as inactive form called pro renin in JG cells of kidneys.
Renin act as enzymes  on an other protein called globulin( angiotensinogen ) .
Angiotensin 1 is converted into angiotensin 2.


MECHANISM ACE
ACE inhibitors lowers BP by reducing PR resistance with out reflexly  increasing COP , heart rate or contractility.
These drugs block the ACE  that cleaves angiotensin 1 to form the potent vaso constrictor angiotensin 2 .
Converting enzyme is also responsible for the  break down of bradykinin levels.
Vaso dilation occurs as a result of decrease angiotensin 2 and increase bradykinin .
By reducing angiotensin 2 ,there is decreased secretion of aldosterone , resulting in decrease sodium and water retention.

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