This document discusses various classes of antihypertensive agents (medications used to treat high blood pressure) including: diuretics, beta blockers, calcium channel blockers, ACE inhibitors, ARBs, and vasodilators. It provides examples of common medications in each class and their mechanisms and indications for treating conditions like hypertension, heart disease, and kidney disease. Side effects are also outlined for some classes like diuretics.

2.  Md. Moshiur Rahman 07 (2047)
 Mehenaj jahan 02 (2042)
 Afzal hoassain 03 (2043)
 Nipa akter 04 (2044)
 Kaniz fatema 08 (2048)
 Samhan afroz 12 (2052)
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5.  Hypertension is another name for high blood
pressure. It can lead to severe complications and
increases the risk of heart disease, stroke, and
death.

6.  Definition: Antihypertensive agent
comprise several classes of
compound with the therapeutic
intention of preventing, controlling,
or treating hypertension.

7. 1. Diuretics.
2. Beta Adrenergic Drug.
3. Calcium Channel Blocker.
4. Agiotensin Receptor Blocker.
5. Agiotensin Converting Enzymatic inhibitor .
6.Direct Arterial Vasodilator
7. Sympatholytics and Adrenergic Blocker

8. Diuretics
Thiazides: Hydrochlorothiazide, Chlorthalidone, Indapamide –
High ceiling: Furosemide, Torsemide, ethacrynic acid. –
K+ Sparing: Spironolactone, Amiloride
ACE inhibitors –
Captopril, Enalapril, Lisinopril, Perindopril, Ramipril,
Fosinopril, etc. •

9.  Angiotensin (AT1 receptor) blockers:
 Losartan, Candesartan,Valsartan, Telmisartan •
 Direct renin inhibitor: Aliskiren
 β Adrenergic blockers: Propranolol, Metoprolol, Atenolol,
etc.
 Calcium channel blockers – Verapamil, Diltiazem,
Nifedipine, Felodipine, Amlodipine,, etc.
 β + α Adrenergic blockers: Labetalol, Carvedilol
 Vasodilators : Hydralazine, Minoxidil, Diazoxide .

10.  Diuretics, also called water pills, are medications
designed to increase the amount of water and salt
expelled from the body as urine.
Types of diuretics
•Thiazides and related diuretics.
•Loop diuretics.
•Potassium sparing diuretics.

12.  Moderate hypertension.
 Edema
 heart failure.
 Kidney disorderes
 Renal impairment: loop diuretics.
 hyperkalaemia

13.  low sodium
 Headache
 dizziness
 Thirst
 muscle cramps
 Skin Rash
 Increase cholesterol
 Gout
 Diarrhoea
 In rare cases, diuretics may cause serious side effects. These can include:
 allergic reaction
 irregular heartbeat
 Kidney failure

14. Thiazide diuretics, such as hydrochlorothiazide and
chlorthalidone, lower blood pressure initially by
increasing sodium and water excretion. Thiazide
diuretics can induce hypokalemia, hyperuricemia
and, to a lesser extent, hyperglycemia in some
patients.

15. Loop diuretics: The loop diuretics act promptly by
blocking sodium and chloride reabsorption in the
kidneys, even in patients with poor renal function or
those who have not responded to thiazide diuretics.
Loop diuretics cause decreased renal vascular
resistance and increased renal blood flow.

16.  K+ Sparing: • potassium-sparing diuretics
(spironolactone, and eplerenone) are competitive
antagonists that either compete with aldosterone,
or directly block epithelial sodium channel
(amiloride)

17. · Diabetes
· high cholesterol
· low amount of magnesium in the blood
· low amount of sodium in the blood
· Loss of Body Water
· Yellowing of the Skin in a Newborn Child

18.  Calcium channel blockers, also called calcium
antagonists, relax and widen blood vessels by affecting
the muscle cells in the arterial walls.
 Types
 Dihydropyridine: nifedipine, amlodipine, felodipine,
nicardipine, lacidipine.
 Non dihydropyridine :
 Phenylalkylamine: verapamil.
 Benzothiazepine: diltiazem.

20.  Ischemic heart disease
 High blood pressure
 Coronary artery disease
 Chest pain (angina)
 Arrhythmia
 Some circulatory conditions,

21.  Calcium enters muscle cell through special voltage
sensitive calcium channel level.
 •Normally L-type of channel s admit Ca+ &
cause depolarization –excitation contraction
couple through phosphorylation of myosin
chain –ctraction of vascular smooth muscle.
 Decrease blood pressure
 Decrease systemic vascular resistance

22.  Angiotensin-converting enzyme (ACE) inhibitors help relax blood
vessels. ACE inhibitors prevent an enzyme in your body from
producing angiotensin II, a substance in your body that narrows
your blood vessels and releases hormones that can raise your
blood pressure.
Examples of ACE inhibitors include:
Benazepril (Lotensin)
Captopril
Enalapril (Vasotec)
Fosinopril

23.  Congestive heart failure.
 High blood pressure
 Coronary artery disease
 Heart failure
 Diabetes
 Certain chronic kidney diseases
 Heart attacks
 Scleroderma
 Migraines

25.  Beta-adrenergic blocking agents, are medications that
reduce your blood pressure.
 Indications of Beta – Adrenergic
 Hypertension associated with coronary artery disease.
 Anxiety
 Myocardial Infraction
 Arrhythmia migraine
 Glaucoma
 Thyro toxicity

27. β-adrenergic blockers are mild antihypertensives and
do not significantly lower BP in normotensives. In
stage 1 cases of hypertensive patients (30 - 40%), β-
adrenergic blockers are used alone.

28.  Propranolol is a first β blocker showed effective in
hypertension and ischemic heart disease.
 • Propranolol has now been largely replaced by
cardioselective β blockers such as metoprolol and
atenolol.
• In severe hypertension, β blockers are especially
useful in preventing the reflex tachycardia that
often results from treatment with direct
vasodilators

29. Angiotensin II receptor blockers
(ARBs) help relax your blood
vessels, which lowers your
blood pressure and makes it
easier for your heart to pump
blood.

30. They act by blocking type I angiotensin II receptors
generally, producing more blockade of the renin -
 angiotensin - aldosterone axis.

31.  Diabetes mellitus
 High blood pressure
 Heart failure
 Kidney failure in diabetes
 Chronic kidney diseases
 tissues

32. Vasodilators are a group of medicines that dilate
(open) blood vessels, which allows blood to flow
more easily.
 Types
hydralazine, diazoxide, nitroprusside,

33.  Vasodilators are a group of medicines that
dilate (open) blood vessels, which allows blood
to flow more easily.
 Types
 : hydralazine, diazoxide, nitroprusside,

35.  Erectile Dysfunction
 Heart Attack
 Heart Failure
 High blood pressure
 Pulmonary Hypertension