Lowering Blood Pressure

renin inhibitor

in combo with glucocorticoids, are used as replacement in adrenal insufficiency

DoC, oral

IV or IM in oil

Use for:HTN (decr vasoconstriction) - esp diabetic nephropathy <--ACE or ARBCHF (incr vasodilation)<-- ACE are DoCPost MI <-- ACE are DoCanginal pain, ischemic eventsall are renal sparing, so they do not increase transglomerular pressure

MOA: blocks conversion of AT I -> AT II and increases activity of bradykinin (which breaks down vasodilators to inactive peptides)(1) decreases production of vasoconstrictors (AT II)(2) decreases destruction of vasodilators (bradykinin)oralhas sulfhydrl grouprenal-sparing (doesn't increase transglomerular pressure)will effectively decrease both AT 1 & AT 2 receptor activityfood reduces bioavailabilty by 25%

b/c it reduces aldosterone secretion, so you're not spilling as much K+

b/c increased bradykinin stimulates the cough reflex

which would lead to glomerular damage

MOA: same as captopril

has carboxyl group instead

which would lead to glomerular damage

which would lead to glomerular damage

MOA: blocks binding of AT II to AT-1 receptors*more efficacious in reducing the action of AT IIactions:inhib contraction of vascular smooth muscledecr catecholamine releasedecr aldosterone biosynthesisdecr thirstdecr ADHdecr AT II mediated changes in renal fxn (ie decr Na retention)decr cellular hypertrophy and hyperplasia

MOA: blocks binding of AT II to AT-1 receptors (same as losartan K)