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    Ace Inhibitori PDF

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    Sami Dayekh
    The document discusses the renin-angiotensin system and its importance in hemodynamics and fluid/electrolyte balance. It describes the production of renin in the kidneys and its regulation through three mechanisms. Angiotensin-converting enzyme (ACE) converts angiotensin I to angiotensin II and inactivates bradykinin. ACE inhibitors work by inhibiting this conversion, affecting both circulating and local renin-angiotensin systems. Common ACE inhibitors and their indications, adverse effects, and contraindications are listed. Angiotensin receptor blockers are also discussed as an alternative class of drugs.

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    Ace Inhibitori PDF

    Uploaded by

    Sami Dayekh
    193 views10 pages
    The document discusses the renin-angiotensin system and its importance in hemodynamics and fluid/electrolyte balance. It describes the production of renin in the kidneys and its regulation through three mechanisms. Angiotensin-converting enzyme (ACE) converts angiotensin I to angiotensin II and inactivates bradykinin. ACE inhibitors work by inhibiting this conversion, affecting both circulating and local renin-angiotensin systems. Common ACE inhibitors and their indications, adverse effects, and contraindications are listed. Angiotensin receptor blockers are also discussed as an alternative class of drugs.

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    The document discusses the renin-angiotensin system and its importance in hemodynamics and fluid/electrolyte balance. It describes the production of renin in the kidneys and its regulation through three mechanisms. Angiotensin-converting enzyme (ACE) converts angiotensin I to angiotensin II and inactivates bradykinin. ACE inhibitors work by inhibiting this conversion, affecting both circulating and local renin-angiotensin systems. Common ACE inhibitors and their indications, adverse effects, and contraindications are listed. Angiotensin receptor blockers are also discussed as an alternative class of drugs.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    193 views10 pages

    Ace Inhibitori PDF

    Uploaded by

    Sami Dayekh
    The document discusses the renin-angiotensin system and its importance in hemodynamics and fluid/electrolyte balance. It describes the production of renin in the kidneys and its regulation through three mechanisms. Angiotensin-converting enzyme (ACE) converts angiotensin I to angiotensin II and inactivates bradykinin. ACE inhibitors work by inhibiting this conversion, affecting both circulating and local renin-angiotensin systems. Common ACE inhibitors and their indications, adverse effects, and contraindications are listed. Angiotensin receptor blockers are also discussed as an alternative class of drugs.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 10

    ACE INHIBITORI I

    BLOKATORI AT RECEPTORA

    Radica Stepanovi Petrovi

    Sistem renin-angiotenzin je vaan za


    hemodinamiku i ravnoteu vode i
    elektrolita.
    Renin - glavno mesto sinteze je bubreg
    granulirane jukstaglomerularne elije (JG)
    u zidu aferentnih arteriola na mestu ulaska
    u glomerul.

    Sekrecija renina iz JG je kontrolisana


    preko 3 mehanizma (2 su lokalnog
    renalnog porekla):
    Prvi intrarenalni mehaniki: faktori koji
    tee da renalni perfuzioni pritisak
    renin (oslobadjanjem PG i
    stimulacijom receptora na istezanje):

    krvnog pritiska
    hipovolemija
    srane aktivnosti
    stenoza aorte ili renalne arterije

    Drugi intrarenalni jonski: ulazak NaCl


    kroz elije macula dense distalnog
    tubula renin . Macula densa prati
    sadraj jona u tubularnij tenosti i alje
    stimulus (PG) JG za sekreciju.
    Trei u CNS-u aktivacijom renalnih
    noradrenergikih nerava aktivacija
    1 receptora u JG renin .

    ANG II inhibira oslobadjanje renina


    mehanizmom negativne povratne
    sprege.
    Angiotenzinogen se primarno sintetie u
    jetri.
    Angiotenzin-konvertujui enzim (ACE) osim konverzije angiotenzina I
    inaktivira kinine bradikinin.
    Ima ga naroito u pluima, ali i u endotelu
    krvnih sudova.

    Cirkuliui i lokalni (tkivni) renin-angiotenzin


    sistem.
    Spoljanji
    Lokalni (tkivni)
    Unutranji
    Spoljanji renin preuzet iz cirkulacije u tkiva
    (vaskularno i dr.)
    Unutranji renin, angiotenzinogen i ACE se
    sintetiu u mnogim tkivima (k. sudovi, srce,
    bubrezi). Znaajno utie na vaskularnu,
    sranu i renalnu f-ju i strukturu.

    Mehanizam dejstva ACEI


    ACEI inhibiraju konverziju angiotenzina I
    u angiotenzin II, kako cirkulatornog tako
    i tkivnog.

    Predstavnici ACEI:
    enalapril (Enalapril)
    fosinopril (Monopril) 10 mg, 20 mg
    ramipril (Tritace)
    lizinopril (Loril)
    kvinapril (Hemokvin)
    cilazapril (Prilazid) 0.5 mg, 1 mg, 2.5
    mg, 5 mg

    ACEI se razlikuju prema 3 osobine:


    - jaina
    - lek ili prolek
    - farmakokinetika
    ACEI se izluuju uglavnom preko
    bubrega.

    Indikacije:
    - hipertenzija
    - srana insuficijencija
    - akutni infarkt miokarda i nakon akutnog
    infarkta miokarda posebno kada postoji
    ventrikularna disfunkcija
    - pacijenti sa velikim rizikom od
    ishemijske bolesti srca
    - dijabetika nefropatija
    - hronina bubrena insuficijencija

    Neeljena dejstva:
    hipotenzija (efekat prve doze)!!
    suvi kaalj 5-20% (bradikinin)
    hiperkalijemija
    akutna renalna insuficijencija
    angioneurotski edem
    promena ukusa

    Kontraindikacije:
    trudnoa
    bilateralna stenoza renalnih arterija, ili

    unilateralna stenoza kod pacijenata sa


    jednim bubregom

    Blokatori receptora za angiotenzin II tip 1


    Za sada vrlo skupi lekovi.
    Predstavnici:
    losartan
    valsartan
    telmisartan

    Indikacije:
    hipertenzija (svi), a neki za sranu
    insuficijenciju i dijabetinu nefropatiju
    Neeljena dejstva:
    Hipotenzija, hiperkalijemija.
    Ne izazivaju kaalj, a angioneurotski
    sindrom mnogo redje nego ACEI.
    Ne u trudnoi.

    10

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