<prompt> Which of the following causes increased renin on prolonged use?ClonidineEnalaprilMethyldopab-blockers  <response>: Ans. is b i.e., Enalapril Drugs increase plasma renin o Diuretics o CCBs o Vasodilators e.g. hydralazine o ACE inhibitors Drugs lower plasma renin o b-blockers o Methyldopa o Clonidine 1. Drugs which increase plasma renin activity Diuretics, vasodilators, CCBs, ACE inhibitors may be combined with drugs which lower plasma renin activity sympatholytic drugs - b-blockers clonidine methyl-dopa. o Renin release is caused by sympathetic b1 receptors on JG cells. o Diuretics, vasodilators. CCBs, ACE inhibitors causes hypotension - reflex sympathetic stimulation - activation of b1, receptors - renin release. o Sympatholytic drugs either block b1 receptors b-blocker or reduce sympathetic outflow central sympatholytic - Renin release. o But among diuretics, osmotic diuretics decrease rennin release. o Osmotic diuretics expands ECF increase intravascular volume - draws water from the intracellular compartment? increases GFR and inhibits renin release. Renin Inhibitors: Aliskiren Remikiren Enakiren 