Vasoactive Peptides

Question 1

angiotensin II, vasopressin, endothelins, and neuropeptide Y are _________

Answer 1

vasoconstrictors

Question 2

bradykinins, natriuretic peptides, vasoactive intestinal peptide, substance P, neurotensin, and calcitonin gene related peptide are __________

Answer 2

vasodilators

Question 3

_______ cells are the site of synthesis, storage, and release of renin, location of macula densa beside renin secreting JG cells in afferent arteriole

Answer 3

granular

Question 4

• increased NaCl flux through chemoreceptors in macula densa
• elevated BP through baroreceptors in afferent arteriole wall
• beta blockade by inhibiting sympathetic stimulation
• negative feedback by angiotensin II

Answer 4

all inhibit renin secretion

Question 5

angiotensin will ______ peripheral resistance to increase afterload, ______ aldosterone secretion to increase preload

Answer 5

increase

increase

Question 6

ACE inhibitors _______ both preload and afterload

Answer 6

decrease

Question 7

only active ACE inhibitor?

Answer 7

captopril

Question 8

• reduce angiotensin vasoconstriction with little reflex tachy
• decrease aldosterone release from adrenal medulla
• reduce destruction of bradykinin - enhance BP lowering, cause cough and angioedema
• renal renin secretion may increase b/c of reduction in negative feedback by AngII

Answer 8

ACE inhibitors

Question 9

• adverse:
• dry, hacking, nonproductive cough
• angioedema, anaphylaxis
• hyperkalemia (due to inhibited aldosterone secretion)
• contraindicated in last 2 trimesters of pregnancy

Answer 9

ACE inhibitors

Question 10

• receptors predominate in vascular smooth muscle and cause the known actions of Ang2
• selective for AT1
• may cause hyperkalemia
• do not affect bradykinin metabolism
• sartans

Answer 10

angiotensin receptor antagonists

Question 11

• reduction in plasma renin activity

- reduce BP

Answer 11

renin inhibitor (aliskiren)

Question 12

• potent arteriodilators formed by kallikreins

- produce pain, swelling, redness

Answer 12

kinins

Question 13

• synthesized in hypothalamus together with oxytocin, secreted from posterior pituitary
• produce antidiuretic and vasopressor effects, (V1-vasoconstriction, V2-antidiuresis)

Answer 13

vasopressin (ADH)

Question 14

• long acting analog with minimal V1 activity

- promotes antidiuresis, deficiency results in diabetes insipidus

Answer 14

desmopressin

Question 15

• drug with both V1a and V2 antagonist effects

- approved for treatment of hyponatremia

Answer 15

conivaptan

Question 16

• potent vasoconstrictor substances, locally acting

- ETA smooth muscle vasoconstriction, ETB release of EDRF and prostanoids

Answer 16

endothelins

Question 17

• vasoconstriction - direct inotropy and chronotropy
• prolonged increase in BP
• contraction of tracheal and bronchial smooth muscle
• decreased GFR
• increased renin

Answer 17

endothelin

Question 18

• nonselective ETA/ETB receptor antagonist
• approved for pulmonary hypertension, decreases pulmonary vascular resistance
• adverse: hypotension, increased HR, hepatotoxicity

Answer 18

bosENtan

Question 19

• developed as analgesic

- prevents chemo induced emesis

Answer 19

aprepitant