1. General Pharmacological Principles
    2. 1. Introduction, Routes of Drug Administration
    2. Pharmacokinetics: Membrane Transport, Absorption and Distribution of Drugs
    3. Pharmacokinetics: Metabolism and Excretion of Drugs, Kinetics of Elimination
    4. Pharmacodynamics: Mechanism of Drug Action; Receptor Pharmacology
    5. Aspects of Pharmacotherapy, Clinical Pharmacology and Drug Development
    6. Adverse Drug Effects
  2. Drug Acting on Autonomic Nervous System
    3. 7. Cholinergic Transmission and Cholinergic Drugs
    8. Anticholinergic Drugs and Drugs Acting on Autonomic Ganglia
    9. Adrenergic Transmission and Adrenergic Drugs
    10. Antiadrenergic Drugs (Adrenergic Receptor Antagonists) and Drugs for Glaucoma
  3. Autacoids and Related Drugs
    4. 11. Histamine and Antihistaminics
    12. 5-Hydroxytryptamine, its Antagonists and Drug Therapy of Migraine
    13. Prostaglandins, Leukotrienes (Eicosanoids) and Platelet Activating Factor
    14. Nonsteroidal Antiinflammatory Drugs and Antipyretic-Analgesics
    15. Antirheumatoid and Antigout Drugs
  4. Respiratory System Drugs
    5. 16. Drugs for Cough and Bronchial Asthma
  5. Hormones and Related Drugs
    6. 17. Anterior Pituitary Hormones
    18. Thyroid Hormones and Thyroid Inhibitors
    19. Insulin, Oral Antidiabetic Drugs and Glucagon
    20. Corticosteroids
    21. Androgens and Related Drugs, Drugs for Erectile Dysfunction
    22. Estrogens, Progestins and Contraceptives
    23. Oxytocin and Other Drugs Acting on Uterus
    24. Hormones and Drugs affecting Calcium balance
  6. Drugs acting on Peripheral nervous system
    7. 25. Skeletal muscle relaxants
    26. Local anaesthetics
  7. Drugs acting on Central nervous system
    8. 27. General anaesthetics
    28. Ethyl and Methyl alcohols
    29. Sedative-Hypnotics
    30. Antiepileptic Drugs
    31. Antiparkinsonian Drugs
    32. Drugs used in Mental Illness: Antipsychotic and Antimanic drugs
    33. Drugs used in Mental Illness: Antidepressant and Antianxiety drugs
    34. Opioid analgesics and antagonists
    35. CNS stimulants and Cognitino enhancers
  8. Cardiovascular drugs
    9. 36. Drugs affecting Renin-Angiotensin system
    37. Nitric oxide and Vasoactive peptide signal molecules
    38. Cardiac glycosides and Drugs for Heart failure
    39. Antiarrhythmic drugs
    40. Antianginal and other Anti-ischaemic drugs
    41. Antihypertensive drugs
  9. Drugs acting on Kidney
    10. 42. Diuretics
    43. Antidiuretics
  10. Drugs affecting blood and Blood formation
    11. 44. Haematinics and Erythropoietin
    45. Drugs affecting Coagulation, Bleeding and Thrombosis
    46. Hypolipidaemic drugs
  11. Gastrointestinal drugs
    12. 47. Drugs for Pepric ulcer and gastroesophageal reflux disease
    48. Antiemetic, Prokinetic and Digestant drugs
    49. Drugs for Constipation and Diarrhoea
  12. Antimicrobial drugs
    13. 50. Antimicrobial drugs: General considerations
    51. Sulfonamides, Cotrimoxazole and Quinolones
    52. Beta-lactam antibiotics
    53. Tetracyclines and Chloramphenicol (Broad-spectrum antibiotics)
    54. Aminoglycosides antibiotics
    55. Macrolide, Lincosamide, Glycopeptide and Other antibacterial antibiotics; Urinary antiseptics
    56. Antitubercular Drugs
    57. Antileprotic Drugs
    58. Antifungal drugs
    59. Antiviral drugs (Non-retroviral)
    60. Antiviral drugs (Anti-retrovirus)
    61. Antimalarial drugs
    62. Antiamoebic and Other antiprotozoal drugs
    63. Antihelmintic drugs
  13. Chemotherapy of Neoplastic diseases
    14. 64. Anticancer drugs
  14. Miscellaneous drugs
    15. 65. Immunosuppressant drugs
    66. Drugs acting on Skin and Mucous membranes
    67. Antiseptics, Disinfectants and Ectoparasiticides
    68. Chelating agents
    69. Vitamins
    70. Vaccine, Antisera and Immunoglobulins
    71. Drug interactions
Cardiovascular drugs
36. Drugs affecting Renin-Angiotensin system
RAS DRUGS
graph TD A(Angiotensinogen - Liver) -->|Low Blood pressure <br> Decrease renal perfusion pressure <br> <b>Renin</b> produced by juxtraglomerular cells of kidney| B(Angiotensin I) B -->|ACE - Lung🫁| C(Angiotensin II) C -->|AT1 receptor| D(Heart🫀) & E(Blood vessels🩸) & F(Kidney🫘) & G(Adrenal gland) & H(Brain🧠) & I(Sympathetic nervous <br>system😱) subgraph Effect of Angiotensin II D --> D1(Increases force,<br> velocity, and <br>rate of heart) E --> E1(Causes vasoconstriction, <br>increases venous return, <br>and cardiac output) F --> F1(Increases absorption of Na<sup>+</sup>) G -->|Increases aldosterone <br>synthesis| G1(Increase Na<sup>+</sup> and<br> water reabsorption <br>and K<sup>+</sup> loss.) & G11(Vasoconstriction.) H --> H1(Activates thirst center) I --> I1(Activates sympathetic<br> activity) end D1 & E1 & F1 & G1 & G11 & H1 & I1 --> J(Increases Blood pressure) J-->K((Decreased <br>Renin <br>production)) X(Bradykinin)-->|ACE - Lung🫁| Y(Inactive peptide) X-->Z(Causes Vasodilation <br>and Cough) Y-->|❌|Z
Angiotensin - 2
Uses
Heart
Increases force, velocity and rate of heart.
Blood vessels
Causes vasoconstriction and thus increases both Venous return and Cardiac output.
Kidney
Increases absorption of Na+.
Adrenal gland
Increases aldosterone synthesis and thus increases the absorption of Na+ and causes vasoconstriction.
Brain
Activates thirst center
Sympathetic nervous system
Activates the sympathetic activity.
Direct renin inhibitor
Drugs
Aliskiren
Mechanism of action
Pharmacokinetics
Pharmacodynamics
Uses
Adverse effect
Contraindication
ACE inhibitor
Drugs
  1. Captopril
  2. Enalapril
  3. Fosinopril
  4. Lisinopril
  5. Perindopril
  6. Ramipril
Table: Comparative features of some ACE inhibitors
Captopril
Enalapril
Fosinopril
Lisinopril
Perindopril
Ramipril
Chemical nature
Sulfhydryl
Carboxyl
Phosphinate
Carboxyl
Carboxyl
Carboxyl
Activity status
Active
Prodrug
Prodrug
Active
Prodrug
Prodrug
Bioavailability (as active form)
70% (Max)
50%
30%
25% (Min)
30–50%
60%
Time to peak action
1 hr
4–6 hr
3–5 hr
6–8 hr
6 hr
3–6 hr
Elimination t½*
2 hr
11 hr
12 hr
12 hr
25–30 hr
8–18 hr
Mode of excretion
Renal
Renal
Renal/hepatic
Renal
Renal
Renal
Duration of action
6–12 hr
24 hr
24 hr
> 24 hr
> 24 hr
> 24 hr
Daily dose (mg)
25–150
2.5–40
10–40
5–40
2–8
1.25–10
*t½ including that of active metabolite
Note
  1. Captopril and Fosinopril are only other than carboxyl compound.
  2. Capropril is prototype drug.
  3. Only Fosinopril have (Renal + Hepatic) mode of excretion, others have only renal mode of excretion.
  4. Captopril and Lisinopril are only active drugs, others all being pro-drugs.
  5. Bioavailability is maximum for Captopril(70%) and minimun for Lisinopril(25%).
Mechanism of action
Inhibits Angiotensin Converting Enzyme(ACE) produced by lung and thus prevent conversion of Angiotensi-I into Angiotensin-II.
Pharmacokinetics
Pharmacodynamics
Uses
  1. Hypertension
  2. Congestive Heart Failure
  3. Myocardial infarction
  4. Prophylaxis in high cardiovascular risk
  5. Diabetic nephropathy
  6. Scleroderma crisis
Adverse effect
  1. Hypotension
    • •
      There is little dilatation of capacitance vessels --> Postural Hypotension is not problem.
    • •
      But because of faster action of Captopril an initial sharp fall in BP first dose hypotension may occur.
    • •
      So start with ½ dose for 1 week before giving full dose.
  2. Foetopathic/ Teratogenic
    • •
      Use during second or third trimester may reduce fetal blood pressure leading to growth retardatioin, anuria and death.
  3. Hyperkalamia
    • •
      It is caused due to decrease aldosterone section. So more retention of potassium.
  4. Acute Renal Failure
  5. Cough
    • •
      It is caused due to suppression of ACE which results in inability to covert Bradykinin into Inactive peptide.
  6. Angioneurotic oedema
  7. Itch (Rashes, Urticaria)
  8. Dysgeusia
  9. Headache, Dizziness, Nausea and Bowel upset
Contraindication
  1. Pregnancy
  2. Allergy or Hypersensitivity
  3. Bilateral Renal artery stenosis
  4. Hyperkalamia
AT1 receptor blocker
Drugs
  1. Candesartan
  2. Losartan
  3. Irbesartan
  4. Olmesartan
  5. Telmisartan
  6. Valsartan
Mechanism of action
Blocks AT1 receptor present on different organs and inhibts its effect.
Pharmacokinetics
Pharmacodynamics
Uses
Adverse effect
Contraindication