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structural feature of ang I and ang II
- ang I is a decapeptide
- ang II is an octapeptide
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natriuretic peptide
ANP increases Na secretion and urine flow, GFR increases, vasodilation, decrease BP(cGMP)
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vasoactive intestinal peptide (VIP)
marked vasodilation independent of NE, ACh, serotonin and histamine receptros
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substance P
potent vasodilator, contraction of venous, intestinal and bronchial SM
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neurotensin
peripheral vasodilator
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calcitonin gene-related peptide (CGRP)
- presents in large quantity in the C cells of the thyroid gland
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neuropeptide Y (NPY)
- functions both as a vasoconstrictor and a cotransmitter with norepinephrine
- CNS: increased feeding
- peripheral: vasoconstriction
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antagonist of neuropeptide
PP56
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which step does ACE inhibitors work on
ang I - ang II
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if a patient with HTN has a night cough complaint which vasoactive drug should be avoided
ACEI
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inducible isoform of NO
iNOS - located in the macrophages of smooth muscle cells
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isoforms of NO that require Ca
- nNOS - located in the neuronal & epithelial cells
- eNOS - located in the endothelial cells
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substrate for NO
L-arginine
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indicator of NO since it has a short half life
L-citrulline
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activated by NO and the response
- NO activates guanylyl cyclase (GC) bound by phosphate and GTP producing increase in cGMP causing myosin relaxation
- vasodilation
- platelet inhibition
- smooth muscle regulation
- immune regulation
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serves as a reservoir for NO
glutathione
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beneficial oxides of nitrogen
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2 signaling pathways useful in practice for NO(I)
- neurons in the brain
- macrophage
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2signaling pathways useful in practice for NO (II)
- dilating blood vessels for erection of the penis
- inhaled for newborn high blood pressure in the lungs
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NO septic shock cause and TX
- increased urinary excretion of nitrates
- Tx - methy blue (GC inhibitor)
- hemoglogin (NO scavenger)
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NO use in atherosclerosis
antioxidant blocking the oxidation of LDL preventing the formation of foam cells in vascular wall (macrophage engulfs)
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excessive NO
detrimental during acute organ rejection due to up-regulation of iNOS by cytokines
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