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  #1  
Old 02-26-2011
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Drug renin-angiotensin-aldosterone system

A 60-year-old male is treated with losartan for hypertension. His blood pressure decreases to normal value over several weeks of treatment. He seems to be compliant with his medication and experiences no significant side effects. Which of the following is the most likely combination of changes in response to this patients treatment?


........Renin ....Angiotensin I ....Angiotensin II ....Aldosterone ....Bradykinin
A. Increase ....Increase .........Decrease ...........Increase .........Increase
B. Increase ....Increase .........Increase ............Decrease .........Increase
C. Increase ....Increase .........Increase ............Decrease .........No change
D. Increase ....Increase .........Decrease ...........Increase .........Decrease
E. Increase ....Decrease ........Decrease ...........Decrease .........Decrease
F. Decrease ...Decrease ........Decrease ...........Increase .........No change
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  #2  
Old 02-26-2011
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losartan z angio receptor blocker
ans z;;; ccccccccc
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  #3  
Old 02-26-2011
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Add My C.

I remember this Q from Guayton Review. It has fantastic chapters of cardio, renal, and respiratory.
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  #4  
Old 02-26-2011
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C

This is a good question.
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  #5  
Old 02-26-2011
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C. this is a good review question
Feel like having seen this question before.Maybe from Uworld
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Old 02-26-2011
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C it is, and I got this one in Uworld.
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Old 02-26-2011
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C....its ARB...used when ACE inhibitor causes side effects due increased level of bradykinin
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Old 02-27-2011
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Arrow C) Increase-Increase-Increase-Decrease-No change

I'm impressed!!! all of you are correct

Correct ans is C) Increase-Increase-Increase-Decrease-No change


The renin-angiotensin-aldosterone system (RAAS) is one of the most important neurohormonal systems that regulate arterial blood pressure and sodium and fluid content in the body. In response to decreased sodium, fluid volume, or arterial blood pressure, renin is released from the kidneys converting angiotensinogen to angiotensin I. Subsequently, angiotensin converting enzyme (ACE) converts angiotensin Ito angiotensin II and is also responsible for the breakdown of bradykinin.

Angiotensin II stimulates angiotensin-1 receptors (AT-1) throughout the body constricting vascular smooth muscle and increasing aldosterone secretion from the adrenal cortex. AT-1 receptors are also involved in a negative feedback mechanism regulating the RAAS. Stimulation of AT-1 receptors on juxtaglomerular cells will decrease renin release from the kidneys, consequently decreasing angiotensin I and II levels.

Angiotensin receptor blockers like losartan (ARB5) competitively bind to AT-i receptors and block the effects of angiotensin II. This will result in vascular smooth muscle relaxation and decreased aldosterone secretion. Since ARBs directly block AT-i receptors, they do not affect ACE activity and should not affect bradykinin degradation or levels.
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Old 12-05-2013
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if it were ACEI how would it be?
Renin would increase?
AT I would increase?
AT II would decrease?
Aldosterone would decrease?
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Old 12-05-2013
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Quote:
Originally Posted by tarihosy View Post
if it were ACEI how would it be?
Renin would increase?
AT I would increase?
AT II would decrease?
Aldosterone would decrease?
Yeah that would have been the answer but u didn't answer for bradykinin.
Am not sure about that.
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