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.