Enalapril aldosterone

Like captopril, enalapril selectively suppresses the rennin-angiotensin-aldosterone system, inhibits angiotensin-converting enzyme, and prevents conversion of angiotensin I into angiotensin 11. 

Enalapril Inhibits conversion of angiotensin I Arteriolar dilation decreased aldosterone Hypertension heart failure... 

Captopril is designated chemically as l-[(2S)-3-mercapto-2-methylpropionyl]-L-proline (14) (Fig. 8). It is used as an antihypertensive agent through suppression of the renin-angiotensin-aldosterone system [36,37], Captopril and other compounds such as enalapril and lisinopril prevent the conversion of angiotensin I to angiotensin II by inhibition of ACE. 

A test dose should be given to patients who are in cardiac failure (or who are already taking a diuretic for another reason, e.g. hypertension). Maintenance of blood pressure in such individuals may depend greatly on an activated renin-angiotensin-aldosterone system and a standard dose of an ACE inhibitor can cause a catastrophic fall in blood pressure. Except for captopril, most ACE inhibitors (including enalapril) are prodrugs, which are inactive for several hours after dosing. This has favoured the use of captopril... 

Enalapril is an ACE inhibitor that competitively inhibits angiotensin I-converting enzyme, preventing conversion of angiotensin I to angiotensin 11, a potent vasoconstrictor that also stimulates release of aldosterone. It results in deaeases in BP, reduced sodium absorption, and potassium retention. Enalapril is indicated in the treatment of hypertension and symptomatic congestive heart failure (CHE) in combination with diuretics and digitalis and asymptomatic left ventricular dysfunction. 

ACE inhibitors (e.g., captopril, enalapril, lisinopril, etc.) compete with angiotensin I for binding of ACE, thus reducing the formation of angiotensin II. This results in decreased vasoconstriction. Secretion of aldosterone is also reduced, resulting in decreased fluid volume, and vasodilatation is promoted through an inhibition of the metabolism of bradykinin, a potent vasodilator. This produces a net vasodilatation, accompanied by a decrease in plasma volume, resulting in a fall in blood pressure. 

Captopril, l-[(2S)-3-mercapto-2-methyl-propionyl]-L-proline, the first orally active inhibitor of the angiotensin-converting enzyme (ACE) on the market. The positive effects of captopril and other ACE inhibitors like enalapril in hypertension and heart failure result primarily from suppression of the renin-angiotensin-aldosterone system. Captopril causes a fall in blood pressure in hypertensive patients [M. A. Ondetti et al.. Science 1977,196,441 ... 

Noveck RJ, McMahon FG, Bocanegra T, Karem A, Sugimoto D, Smith M. Effects of oxa-prozin on enalapril and enalaprilat pharmacokinetics, pharmacodynamics blood pressure, heart rate, plasma renin activity, aldosterone and creatinine clearances, in hypertensive patients. Clin Pharmacol Ther ( 997), 61,208. 

Not understood. One suggestion is that eielosporin reduces renal blood flow and reduces perfusion through the glomerulus, which is worsened when angiotensin n is inhibited by the ACE inhibitor. One study suggested that the larger increase in potassium levels may be related to changes in aldosterone levels seen with enalapril. ... 

Combination studies Dual blockade of the renin-angiotensin-aldosterone system by combined use of angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor antagonists may provide more renal protection than monotherapy in chronic kidney disease. In 45 patients with chronic kidney disease who took either enalapril 20 mg/day or candesartan 16 mg/ day for 16 weeks followed by treatment, with incremental dosing of enalapril (target... 

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