Antihypertensive agent

تـاريخ التسـجـيل : 07/11/2010

Antihypertensive agent

1. Direct acting vasodilator

2. Centrally acting antihypertensive drugs

3. Adrenergic neuron blocking agent

4. Alpha adrenoreceptor blocking drugs

5. Beta adrenoreceptor blocking drugs

6. Drug affecting the rennin angiotensin system

7. Calcium channel blocker

8. Diuretics

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تـاريخ التسـجـيل : 07/11/2010

1- Direct acting vasodilator

-Drug: Hydralazine

-Mechanism: arteriolar dilatation

-Indication: Moderate HTN

-Side effects: tachycardia

-Drug: Minoxidel

-Mechanism: arteriolar dilatation

-Indication: Moderate HTN

-Side effects: tachycardia

-Drug: Diazoxide

-Mechanism: arteriolar dilatation

-Indication: HTN emergency

-Side effects: tachycardia

-Drug: Nitroprusside

-Mechanism: Veno-arteriolar dilatation

-Indication: HTN emergency

-Side effects: tachycardia

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تـاريخ التسـجـيل : 07/11/2010

1- Centrally acting

-Drug: Methyl dopa

-Mechanism: α2 agonist

-Indication: Moderate HTN

-Side effects: Sedation, dizziness

-Drug: Clonidine

-Mechanism: α2 agonist

-Indication: Moderate HTN

-Side effects: Sedation, rebound hypertension

N.B: methyl dopa (aldomet®) D.O.C drug of choice in pregnancy

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تـاريخ التسـجـيل : 07/11/2010

1- Adrenergic neuron blocker

-Drug: reserpine

-Mechanism: Inhibit NE release

-Indication: HTN

-Side effects: Sedation, depression

-Drug: guanithidine

-Mechanism: Inhibit NE release

-Indication: HTN

-Side effects: Orthostatic hypotension

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تـاريخ التسـجـيل : 07/11/2010

1- Alpha adrenoreceptor blocking drugs

-Drug: prazocin

-Mechanism: Alpha (α1) blocker

-Indication: HTN

-Side effects: Orthostatic hypotension

-Drug: terazocin

-Mechanism: Alpha (α1) blocker

-Indication: HTN

-Side effects: Orthostatic hypotension

-Drug: doxazocin

-Mechanism: Alpha (α1) blocker

-Indication: HTN

-Side effects: Orthostatic hypotension

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تـاريخ التسـجـيل : 07/11/2010

1- Beta (β) blocker

-Drug: Propranolol Inderal ®

-Mechanism: Non selective β blocker

-Indication: HTN, angina , arrhythmia

-Side effects: Asthma, CHF, bradycardia

-Drug: Pindalol

-Mechanism: Non selective β blocker

-Indication: HTN, angina , arrhythmia

-Side effects: Asthma, CHF, bradycardia

-Drug: Atenolol Tenormine®

-Mechanism: beta ( β 1) blocker

-Indication: HTN, angina , arrhythmia

-Side effects: CHF, bradycardia

-Drug: esmolol

-Mechanism: beta ( β 1) blocker

-Indication: HTN, angina , arrhythmia

-Side effects: CHF, bradycardia

N.B:

Used I.V for hypertensive emergencies

Note propranolol is contraindicated with asthmatic patient

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تـاريخ التسـجـيل : 07/11/2010

1- Drug affecting angiotensin system

-Drug: Captopril Capoten ®

-Mechanism: ACEInh

-Indication: HTN, angina ,arrhythmia

-Side effects: Cough, Hypotension, Proteinuria, Fetal renal damage (C.I.in pregnancy) hyperkalemia

-Drug: lisinopril

-Mechanism: ACEInh

-Indication: HTN, angina ,arrhythmia

-Side effects: Cough, Hypotension, Proteinuria, Fetal renal damage (C.I.in pregnancy) hyperkalemia

-Drug: enalapril

-Mechanism: ACEInh

-Indication: HTN, angina ,arrhythmia

-Side effects: Cough, Hypotension, Proteinuria, Fetal renal damage (C.I.in pregnancy) hyperkalemia

-Drug: losartan

-Mechanism: (AT-1) blocker

-Indication :HTN, angina ,arrhythmia

-Side effects:As ACEInh without cough

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تـاريخ التسـجـيل : 07/11/2010

1- Calcium channel blocker

-Drug: Verapamil

-Mechanism: (CCBs)

-Indication: HTN, angina , arrhythmia

-Side effects: Constipation , nausea, heart block

-Drug: diltiazem

-Mechanism: (CCBs)

-Indication: HTN, angina , arrhythmia

-Side effects: Constipation , nausea, heart block

-Drug: Amlodipine

-Mechanism: (CCBs)

-Indication: HTN, angina , arrhythmia

-Side effects: Constipation , nausea

-Drug: nifedipine

-Mechanism: (CCBs)

-Indication: HTN, angina , arrhythmia

-Side effects: Constipation , nausea, flushing, tachycardia

N.B:

Verapamil , diltiazem block Ca on heart

Amlodipine , nifedipine block Ca on Blood vessel

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تـاريخ التسـجـيل : 07/11/2010

1- Diuretics

Classification:

v Carbonic Anhydrase inhibitor

v Osmotic diuretic

v Loop Diuretics

v Thiazides diuretic

v Potassium Sparing diuretic

· Carbonic Anhydrase inhibitor:

-Example:

Acetazolamide, Dorzolamide

-Mechanism:

Carbonic Anhydrase inhibitor

-Uses:

Glaucoma

-Adverse effect:

Hypokalemia

· Osmotic diuretic

-Example:

Mannitol i.v

-Mechanism:

Osmosis

-Uses:

1-Glaucoma

2-Decrease intra cranial pressure

-Adverse effect:

Edema dehydration

· Loop Diuretics

-Example:

Ethacrynic Acid, Furosemide and Bumetanide.

-Mechanism:

Inhibit Na & Cl reabsorption

-Uses:

Edematous state (CHF, pulmonary edema,……)

-Adverse effect:

Hyponatermia, hypokalemia, hypocalcemia and ototoxic

· Thiazides diuretic

-Example:

Chlorothiazide, Hydrochlorothiazide and indepamide.

-Mechanism:

Inhibit Na & Cl Reabsorption

-Uses:

Edematous state (CHF, Pulmonary edema,……)

-Adverse effect:

Hyponatermia, hypokalemia, Hypercalcemia and No ototoxic

· Potassium Sparing diuretic:

-Example:

Spironolactone, Triamterene and Amilorid

-Mechanism:

1-Aldosterone antagonist

2-non Aldosterone antagonist

-Uses:

Potassium depletion CHF hypertension

-Adverse effect:

hyperkalemia, gynecomastia and anti-androgenic

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