Main and important classes of anti-hypertensive drugs. (antihypertensive drugs, anti hypertensive sites of action, diuretics, diuretics sites of action, sympathoplegic drugs, beta blockers, alpha blokers, vasodilators, calcium channel blockers)

1. ANTIHYPERTENS
IVE DRUGS

4. DIURETICS
 Depletes body sodium stores
 Thiazides (25mg) – mild, moderate
 Old age, blacks, heart failure
 Furosemide (20 -40mg) – severe, multiple drugs
with sodium retaining properties, cardiac failure,
cirrosis
A/E : Hypokalemia ( digitalis), Hemolytic
anemias
Hypomagnesimia, impair glucose tolerance, lipid,
gout

6. CENTRALLY ACTING
SYMPATHOPLEGIC
DRUGS
 Methyldopa (1gm/d) - pregnancy
 Lowers PVR – central post α receptors –
baroreceptor reflexes
 PK; aromatic aminoacid transporter
 Useful in HT in renal failure pts
 A/E; Sedation,depression, lassitude
 Extrapyramidal signs
 Hemolytic anemia – coombs test > 12 months
 Prolactin
 Hepatitis and drug fever

8. Β-BLOCKERS

9.  Metaprolol (50mg) & atenolol (50mg); cardioselective, less potent
 Advantages – asthma, PVD, DM
 Sustained formulations – HT with CHF
 Atenolol cautious in renal failure pts
 Pindolol (10 mg)– intrinsic symapthetic activity
 Labetolol ( 200 mg) α β blocker
 Uses; pheochromacytoma and hypertensive emergencies
 Carvedilol; effective antiHT – CHF
 Esmolol ( 0.5 mg /kg) intraoperative and postoperative
management

10. Α BLOCKERS

11. VASODILATORS
 Hydralazine (40 mg/d) & minoxidil (5-10 mg/d)
 K efflux – hyperpolarisation, direct vasodilation
 Reflex tachycardia – atenolol
 Uses – severe and pregnancy induced HT
 A/E; Headache, tachycardia, nausea, sweating,
arrhythmia, lupus like reaction

12.  Minoxidil – selective action on arterioles
 Uses- severe to malignant hypertension
refractory conditions
 Reflex tachycardia, sodium and water retention

13. CALCIUM CHANNEL
BLOCKERS
 Old age, blacks, angina, arrhythmias, isolated
systolic hypertension, DM, PVD
 DHPs: nifedipine (30mg)
 Selective affinity for vascular smooth muscle
 A/E; dizziness, headache, feeling of fatigue
 Gingival enlargement

14. ACE INHIBITORS
 Lisinopril (10mg)
 Preferred when diuretics ineffective
 Uses- white and young, with diuretic for blacks,
DM, ventricular remodelling in MI, CHF, HT in
renal failure pts
 A/E; dry cough, rash, fever, altered taste
hyperkalemia
 Teratogenic