Anti-hypertensive ( Renin inhibitors)



Anti-hypertensive ( Renin inhibitors) 

Drugs: 

Aliskiren


Mechanism of action: 

And as we all know that the process of converting angiotensinogen into angiotensin I requires the secretion of renin from the kidneys to complete this process, therefore Aliskiren works to inhibit renin and when inhibiting renin produces a set of results that include: 

1- It stops the conversion of angiotensin I to angiotensin II.

2- Decreased aldosterone activity, which leads to reduced sodium and water retention and thus lower blood pressure.

3- Increasing the level of bradykinin, which leads to an increase in nitric oxide (works on vasodilation of vascular smooth muscle), which ultimately leads to a decrease in blood pressure.

4- Reducing the output of sympathetic nervous system, which leads to a reduction in blood pressure.


Pharmacological action ( same as ACE inhibitors) : 

These drugs dilate both arterioles and veins, so the work of the heart is reduced due to a reduction in both preload and afterload. These drugs also help prevent angina, myocardial infarction, and cardiac failure because these drugs do not increase myocardial contractility , Aliskiren increases the level of bradykinin (similar to a group of angiotensin converting enzyme inhibitors).


They have compelling indications for use in hypertension patients with ( same as Angiotensin II receptor blockers drug) such as :

  • High coronary disease risk 
  • Heart failure 
  • Myocardial infarction 
  • Stroke 
  • Chronic kidney disease


Side effect: 

  • Dry cough 
  • Fever 
  • Rash 
  • Hypotension 
  • Diarrhea ( most common) 
  • Altered taste
  • Angioedema 
  • Hyperkalemia ( Therefore, when potassium supplements are used with Aliskiren, potassium levels must be strictly monitored frequently. )


Contraindications: 

Avoid using renin inhibitors (Aliskiren) with pregnant women and lactation to avoid fetal malformations.

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