Angiotensin II (medication)

Source: Wikipedia, the free encyclopedia.
Angiotensin II
Vasoconstrictor
ATC code
Legal status
Legal status
Angiotensin III, angiotensin-(1-7)
Elimination half-lifeLess than one minute (IV administration)
Identifiers
  • L-alpha-aspartyl-L-arginyl-L-valyl-L-tyrosyl-L-isoleucyl-L-histidyl-L-prolyl-L-phenylalanine
JSmol)
  • CC[C@H](C)[C@@H](C(=O)N[C@@H](CC1=CN=CN1)C(=O)N2CCC[C@H]2C(=O)N[C@@H](CC3=CC=CC=C3)C(=O)O)NC(=O)[C@H](CC4=CC=C(C=C4)O)NC(=O)[C@H](C(C)C)NC(=O)[C@H](CCCN=C(N)N)NC(=O)[C@H](CC(=O)O)N
  • InChI=InChI=1S/C50H71N13O12/c1-5-28(4)41(47(72)59-36(23-31-25-54-26-56-31)48(73)63-20-10-14-38(63)45(70)60-37(49(74)75)22-29-11-7-6-8-12-29)62-44(69)35(21-30-15-17-32(64)18-16-30)58-46(71)40(27(2)3)61-43(68)34(13-9-19-55-50(52)53)57-42(67)33(51)24-39(65)66/h6-8,11-12,15-18,25-28,33-38,40-41,64H,5,9-10,13-14,19-24,51H2,1-4H3,(H,54,56)(H,57,67)(H,58,71)(H,59,72)(H,60,70)(H,61,68)(H,62,69)(H,65,66)(H,74,75)(H4,52,53,55)/t28-,33-,34-,35-,36-,37-,38-,40-,41-/m0/s1
  • Key:CZGUSIXMZVURDU-JZXHSEFVSA-N

Angiotensin II (Ang II) is a medication that is used to treat

angiotensin II[1] and is marketed under the brand name Giapreza. The Food and Drug Administration approved the use of angiotensin II in December 2017 to treat low blood pressure resulting from septic shock.[2]

The U.S. Food and Drug Administration (FDA) considers it to be a first-in-class medication.[3]

Medical uses

Angiotensin II is a

epinephrine) and non-catecholamine (e.g., vasopressin
). but these agents are not always effective in reversing vasodilatory shock, and their use can be associated with significant side effects including
limb ischemia and cardiac arrhythmia
. Angiotensin II is as a treatment option that can increase blood pressure and allow catecholamine dose reductions.

Angiotensin II must be administered as an

central venous line is recommended. Monitor blood pressure response and titrate angiotensin II every 5 minutes by increments of up to 15 ng/kg/min as needed to achieve or maintain target blood pressure.[7]

Adverse effects

Angiotensin II treated patients are at an increased risk of

thromboembolic events. There was a higher incidence of arterial and venous thrombotic and thromboembolic events in patients who received angiotensin II compared to placebo treated patients in the ATHOS-3 study [13% (21/163 patients) vs. 5% (8/158 patients)].[8] It is recommended that patients be on concurrent venous thromboembolism prophylaxis. Other adverse reactions include thrombocytopenia, tachycardia, fungal infection, delirium, acidosis, hyperglycemia, and peripheral ischemia.[7]

Angiotensin II acts on Angiotensin receptor (AT1) on presynaptic adrenergic nerves → release of catecholamine → excessive catecholamine can be harmful as it can cause myocyte necrosis.[9]

Interactions

Angiotensin II receptor blockers, as their name implies, block the action of angiotensin II at its receptors and therefore may reduce its effects.

References

  1. PMID 29491694
    .
  2. ^ "FDA approves drug to treat dangerously low blood pressure" (Press release). U.S. Food and Drug Administration (FDA). 21 December 2017.
  3. ^ New Drug Therapy Approvals 2017 (PDF). U.S. Food and Drug Administration (FDA) (Report). January 2018. Retrieved 16 September 2020.
  4. PMID 22911566
    .
  5. PMID 25286986
    .
  6. PMID 16694877
    .
  7. ^ a b "Giapreza- angiotensin ii injection". DailyMed. 20 June 2020. Retrieved 17 September 2020.
  8. S2CID 205102054
    .
  9. S2CID 22420796
    .

External links
Retrieved from "https://en.wikipedia.org/w/index.php?title=Angiotensin_II_(medication)&oldid=1193810658"