Which of the following causes increased renin on prolonged use?
Ans. is 'b' i.e., Enalapril Drugs increase plasma renin o Diuretics o CCBs o Vasodilators (e.g. hydralazine) o ACE inhibitors Drugs lower plasma renin o b-blockers o Methyldopa o Clonidine 1. Drugs which increase plasma renin activity (Diuretics, vasodilators, CCBs, ACE inhibitors) may be combined with drugs which lower plasma renin activity (sympatholytic drugs - b-blockers clonidine methyl-dopa). o Renin release is caused by sympathetic b1 receptors on JG cells. o Diuretics, vasodilators. CCBs, ACE inhibitors causes hypotension - reflex sympathetic stimulation - activation of b1, receptors -| renin release. o Sympatholytic drugs either block b1 receptors (b-blocker) or reduce sympathetic outflow (central sympatholytic ) - | Renin release. o But among diuretics, osmotic diuretics decrease rennin release. o Osmotic diuretics expands ECF (increase intravascular volume) - draws water from the intracellular compartment? increases GFR and inhibits renin release. Renin Inhibitors: Aliskiren Remikiren Enakiren
Clonidine
Enalapril
Methyldopa
b-blockers