This document discusses various classes of antihypertensive agents used to treat high blood pressure. It describes how blood pressure is regulated and defines several major classes of antihypertensive drugs, including alpha-1 blockers, beta blockers, calcium channel blockers, diuretics, and agents acting on the renin-angiotensin-aldosterone system. Specific examples of drugs from each class are provided. Other antihypertensive agents that do not fit into the major classes are also mentioned.
This document discusses various classes of antihypertensive drugs used to treat high blood pressure. It describes 7 classes: diuretics, beta blockers, calcium channel blockers, ACE inhibitors, angiotensin receptor blockers, sympatholytic and alpha adrenergic blockers, and direct arterial vasodilators. For each class, it provides examples of drugs, their mechanisms of action, advantages, indications, side effects and other relevant information. Diuretics are further broken down into their types, mechanisms, effects and side effects.
Antihypertensives | Classes of Drugs | Baro ReceptorChetan Prakash
This Presentation provides a knowledge about Antihypertensives, types of blood pressure, hypertension types, normal blood pressure regulation, baro receptors, classes of antihypertensive drugs,recent discovery on hypertension. This is an assignment for the subject, Advanced Pharmacology-I, 1st year M.Pharm, 1st semester.
This document discusses the classification and mechanisms of action of various classes of antihypertensive drugs used to treat hypertension. It describes beta blockers, diuretics, ACE inhibitors, angiotensin II receptor blockers, and calcium channel blockers. For each class, it provides details on their mechanisms of action in lowering blood pressure, medical uses for treating conditions like heart failure and hypertension, and potential side effects. The document aims to explain the pharmacology of antihypertensive drugs and help understand their different classifications and mechanisms of action.
Blood pressure is the force of the blood pushing against the walls of the arteries.
Each time our heart beats pumps blood into the arteries.
Blood pressure is highest when the heart beats, pumping the blood. This is called systolic pressure.
When our heart is at rest, between beats, our blood pressure falls. This is called diastolic pressure.
A blood pressure reading uses these two numbers. Usually, the systolic number comes before or above the diastolic number.
This document provides an overview of antihypertensive agents (blood pressure medications). It discusses the types and classes of antihypertensives, including diuretics, ACE inhibitors, angiotensin receptor blockers, calcium channel blockers, beta blockers, and alpha blockers. It describes the mechanisms of action, therapeutic uses, and potential side effects of each class. The document is intended to teach healthcare providers about selecting and utilizing different antihypertensive drugs to treat hypertension.
- Antihypertensive drugs work to lower blood pressure through various mechanisms such as diuretics which reduce sodium and water retention, ACE inhibitors which decrease angiotensin II levels, beta blockers which block adrenoreceptors, and calcium channel blockers/vasodilators which cause arterial dilation.
- Treatment involves initially prescribing a single drug from one class or a two drug combination for more severe hypertension. The drug classes include diuretics, ACE inhibitors, angiotensin receptor blockers, beta blockers, calcium channel blockers, alpha blockers, central sympatholytics, and vasodilators. Combinations should avoid duplicating mechanisms of action.
- Guidelines recommend beginning therapy
This document provides information on cardiovascular drugs and the hemostasis process. It discusses several types of cardiovascular drugs used to treat conditions like high blood pressure, angina, heart failure, and arrhythmias. These include anticoagulants, antiplatelets, thrombolytic agents, ACE inhibitors, ARBs, diuretics, vasodilators, statins, and drugs that regulate heart rhythm. It also describes the mechanisms and examples of different types of anticoagulants and antithrombotic agents. Finally, it discusses the process of hemostasis and its importance in wound healing, surgery, and trauma management.
This document discusses various classes of antihypertensive drugs used to treat high blood pressure. It describes 7 classes: diuretics, beta blockers, calcium channel blockers, ACE inhibitors, angiotensin receptor blockers, sympatholytic and alpha adrenergic blockers, and direct arterial vasodilators. For each class, it provides examples of drugs, their mechanisms of action, advantages, indications, side effects and other relevant information. Diuretics are further broken down into their types, mechanisms, effects and side effects.
Antihypertensives | Classes of Drugs | Baro ReceptorChetan Prakash
This Presentation provides a knowledge about Antihypertensives, types of blood pressure, hypertension types, normal blood pressure regulation, baro receptors, classes of antihypertensive drugs,recent discovery on hypertension. This is an assignment for the subject, Advanced Pharmacology-I, 1st year M.Pharm, 1st semester.
This document discusses the classification and mechanisms of action of various classes of antihypertensive drugs used to treat hypertension. It describes beta blockers, diuretics, ACE inhibitors, angiotensin II receptor blockers, and calcium channel blockers. For each class, it provides details on their mechanisms of action in lowering blood pressure, medical uses for treating conditions like heart failure and hypertension, and potential side effects. The document aims to explain the pharmacology of antihypertensive drugs and help understand their different classifications and mechanisms of action.
Blood pressure is the force of the blood pushing against the walls of the arteries.
Each time our heart beats pumps blood into the arteries.
Blood pressure is highest when the heart beats, pumping the blood. This is called systolic pressure.
When our heart is at rest, between beats, our blood pressure falls. This is called diastolic pressure.
A blood pressure reading uses these two numbers. Usually, the systolic number comes before or above the diastolic number.
This document provides an overview of antihypertensive agents (blood pressure medications). It discusses the types and classes of antihypertensives, including diuretics, ACE inhibitors, angiotensin receptor blockers, calcium channel blockers, beta blockers, and alpha blockers. It describes the mechanisms of action, therapeutic uses, and potential side effects of each class. The document is intended to teach healthcare providers about selecting and utilizing different antihypertensive drugs to treat hypertension.
- Antihypertensive drugs work to lower blood pressure through various mechanisms such as diuretics which reduce sodium and water retention, ACE inhibitors which decrease angiotensin II levels, beta blockers which block adrenoreceptors, and calcium channel blockers/vasodilators which cause arterial dilation.
- Treatment involves initially prescribing a single drug from one class or a two drug combination for more severe hypertension. The drug classes include diuretics, ACE inhibitors, angiotensin receptor blockers, beta blockers, calcium channel blockers, alpha blockers, central sympatholytics, and vasodilators. Combinations should avoid duplicating mechanisms of action.
- Guidelines recommend beginning therapy
This document provides information on cardiovascular drugs and the hemostasis process. It discusses several types of cardiovascular drugs used to treat conditions like high blood pressure, angina, heart failure, and arrhythmias. These include anticoagulants, antiplatelets, thrombolytic agents, ACE inhibitors, ARBs, diuretics, vasodilators, statins, and drugs that regulate heart rhythm. It also describes the mechanisms and examples of different types of anticoagulants and antithrombotic agents. Finally, it discusses the process of hemostasis and its importance in wound healing, surgery, and trauma management.
This document discusses the etiology, classification, and treatment of hypertension. It begins by explaining that the cause of essential or primary hypertension is unknown in most cases, while secondary hypertension has an identifiable cause. It then covers the classification of hypertension by blood pressure levels. The rest of the document details the mechanisms regulating blood pressure, various classes of antihypertensive drugs including diuretics, ACE inhibitors, ARBs, beta blockers, and calcium channel blockers, and guidelines for treating different stages of hypertension.
The urinary system drugs document discusses several classes of drugs used to treat conditions of the urinary system. It begins by describing the anatomy and physiology of the urinary system and its functions of regulating blood volume, waste removal, and urine formation. It then discusses several classes of diuretic drugs that increase urine production including thiazides, loop diuretics, potassium-sparing diuretics, and carbonic anhydrase inhibitors. It also discusses drugs that lower blood pressure such as ACE inhibitors, calcium channel blockers, and beta-blockers. The document concludes by covering treatments for conditions like urolithiasis, urinary incontinence, and overactive bladder.
This document summarizes various classes of antihypertensive drugs. It discusses how diuretics like thiazide and loop diuretics work to reduce blood pressure by increasing sodium excretion. It also covers ACE inhibitors which work by inhibiting angiotensin-converting enzyme and blocking vasoconstriction and sodium retention. Angiotensin receptor blockers produce similar effects. Other classes discussed include beta blockers, alpha blockers, direct renin inhibitors, calcium channel blockers, and central sympatholytics. Specific drugs within each class are provided along with their mechanisms and uses for treating hypertension.
The document discusses several classes of drugs used to treat cardiovascular conditions. It describes the mechanisms of calcium channel blockers, diuretics, vasodilators, cardiac glycosides, alpha blockers, beta blockers, ACE inhibitors, and ARBs. Calcium channel blockers work by blocking calcium entry into cells to decrease contraction. Diuretics reduce fluid volume to decrease preload and workload on the heart. ACE inhibitors block angiotensin conversion to lower blood pressure.
Heart failure occurs when the heart is unable to pump enough blood to meet the body's needs. It has a high mortality rate. The most common cause is coronary artery disease. When the heart does not contract well, blood backs up in the lungs and periphery. Chronic activation of compensatory mechanisms like the sympathetic nervous system contributes to cardiac remodeling over time.
Right heart failure causes issues like leg swelling and liver enlargement due to blood backing up. Left heart failure can cause pulmonary edema. Treatment focuses on reducing symptoms, slowing disease progression, and improving survival through drugs that target the renin-angiotensin-aldosterone system, beta-blockers, diuretics, and vasodilators. Dentists
This document discusses hypertension and classifications of blood pressure. It then summarizes various categories of antihypertensive agents including their mechanisms of action, examples of medications, therapeutic uses, and side effects. Nursing implications are provided around monitoring blood pressure during therapy, ensuring proper administration of medications, and lifestyle education to support treatment.
This document discusses several classes of cardiovascular drugs including:
- Antihypertensive drugs such as ACE inhibitors, ARBs, beta-blockers, calcium channel blockers, and diuretics which are used to treat high blood pressure.
- Beta-blockers which reduce blood pressure by blocking epinephrine and causing the heart to beat more slowly. They are used for heart disease, hypertension, arrhythmias, and other conditions.
- Loop diuretics which are used to treat fluid overload conditions.
- Vasodilators which open blood vessels to improve blood flow by relaxing vessel walls.
- Antiarrhythmic drugs which treat abnormal heart rhythms by modifying the heart
This document provides information about ACE inhibitors, which are a class of drugs used to treat hypertension. It begins by defining hypertension and describing antihypertensive drugs. It then focuses on ACE inhibitors, explaining their mechanism of action in blocking the conversion of angiotensin I to angiotensin II, thereby reducing vasoconstriction and sodium retention. The document outlines the therapeutic uses of ACE inhibitors for conditions like heart failure and kidney disease, and discusses potential adverse effects like cough, hypotension, and hyperkalemia. It concludes by listing contraindications like previous angioedema or hypersensitivity to ACE inhibitors.
This document discusses antihypertensive agents used to treat hypertension. It describes different categories of agents including adrenergic agents, ACE inhibitors, angiotensin II receptor blockers, calcium channel blockers, diuretics, and vasodilators. For each category, it covers mechanisms of action, examples of medications, therapeutic uses, and potential side effects. It emphasizes the importance of monitoring blood pressure during therapy and avoiding abruptly stopping medications.
This document discusses antihypertensive agents used to treat hypertension. It describes different categories of agents including adrenergic agents, ACE inhibitors, angiotensin II receptor blockers, calcium channel blockers, diuretics, and vasodilators. For each category, the document outlines mechanisms of action, examples of medications, therapeutic uses, and potential side effects. It emphasizes the importance of monitoring blood pressure during therapy and avoiding abruptly stopping medications.
This document discusses various classes of drugs used to treat hypertension, including their mechanisms and side effects. It describes how diuretics, ACE inhibitors, calcium channel blockers, alpha/beta blockers, and other classes work to lower blood pressure by relaxing blood vessels, reducing fluid retention, or inhibiting hormone systems like renin-angiotensin-aldosterone. Common side effects across drug classes include low blood pressure, dizziness, fatigue, and electrolyte imbalances. Regular monitoring is important when taking antihypertensive medications.
The document discusses the regulation of blood pressure and hypertension. It defines normal blood pressure and hypertension. The causes of primary and secondary hypertension are described. The pathophysiology involves the baroreflex and renin-angiotensin-aldosterone system. Treatment includes non-pharmacological methods as well as various classes of antihypertensive drugs such as ACE inhibitors, calcium channel blockers, diuretics, and beta blockers. The mechanisms of action, uses, and side effects of these drug classes are explained in detail.
1. The document discusses antihypertensive drugs, their mechanisms of action, and treatment of hypertension. It covers major classes of antihypertensive drugs including diuretics, ACE inhibitors, angiotensin receptor blockers, beta blockers, calcium channel blockers, and vasodilators.
2. It provides details on how each drug class lowers blood pressure by reducing peripheral vascular resistance, cardiac output, or sodium retention. Common side effects and advantages are also summarized for each drug class.
3. Guidelines for treating different stages of hypertension are presented, including recommendations to start with monotherapy or 2-drug combinations depending on severity, and to follow an A-B-C-D approach
This document discusses various classes of antihypertensive agents including: diuretics, beta blockers, calcium channel blockers, ACE inhibitors, angiotensin receptor blockers, and direct arterial vasodilators. It provides details on the mechanisms of action, indications, side effects and contraindications of each class. The document was submitted by Md.Moshiur Rahman from Gono Bishwabidyalay as an assignment on antihypertensive agents to his lecturer Mst. Rozina Parul.
This document provides guidelines for combination therapy for hypertension. It begins by classifying blood pressure and outlining initial drug therapy options for different BP levels, with or without compelling indications. It recommends thiazide-type diuretics, ACE inhibitors, ARBs, beta-blockers, or calcium channel blockers. The document then discusses reasons for treatment unresponsiveness and inadequate control, and provides support for combination therapy to control BP for 48-51% of patients. It outlines recommended two-drug combination therapies and cautions about their initial use.
1. Drugs Hypertesnion, heart failure and arryhthmia.pptxweldat1
This document discusses drug therapy for hypertension. It begins by defining hypertension and classifying blood pressure readings. Lifestyle modifications that can help control hypertension are described, including weight loss, reducing salt intake, moderating alcohol, and exercise. Pharmacological treatments are then outlined, with diuretics being the first-line treatment. The document focuses on different classes of diuretics including thiazides, loop diuretics, and potassium-sparing diuretics. Adverse effects of diuretics like hypokalemia are also covered.
This document discusses hypertension (high blood pressure) including its causes, mechanisms of blood pressure control, and antihypertensive drug treatments. It describes how hypertension is defined and its prevalence. It explains the roles of the baroreceptor and renin-angiotensin-aldosterone systems in long-term and short-term blood pressure regulation. Finally, it provides details on major classes of antihypertensive drugs including diuretics, beta blockers, ACE inhibitors, angiotensin receptor blockers, calcium channel blockers, and others.
This document discusses cardiovascular drugs used to treat various conditions. It covers drugs that affect the renin-angiotensin-aldosterone system like ACE inhibitors and ARBs to treat hypertension. It also discusses calcium channel blockers, beta blockers, and diuretics for hypertension. For angina, it outlines organic nitrates, beta blockers, and calcium antagonists. Antiarrhythmic drugs are broken down by class. Drugs to treat heart failure include digitalis compounds, diuretics, ionotropic drugs, vasodilators, and beta blockers.
This document discusses various classes of antihypertensive drugs used to treat hypertension. It describes the mechanisms of action, effects, and side effects of different classes including diuretics, ACE inhibitors, angiotensin receptor blockers, direct renin inhibitors, beta blockers, and calcium channel blockers. Diuretics work by increasing sodium excretion while ACE inhibitors and angiotensin receptor blockers block the renin-angiotensin-aldosterone system. Beta blockers inhibit sympathetic stimulation to lower blood pressure. Each class lowers blood pressure through different mechanisms in the body.
Antihypertensive drugs and hypertension managementAnas Indabawa
This document discusses antihypertensive drugs and hypertension management. It begins with an introduction to hypertension and outlines types of hypertension like primary or essential hypertension. It then discusses risk factors, diagnosis, and management of hypertension including both non-pharmacological lifestyle changes and various classes of pharmacological treatments. Specific drug classes are explained like ACE inhibitors, calcium channel blockers, diuretics, and others. The document also covers hypertension during pregnancy and hypertensive emergencies. It concludes with precautions for using antihypertensive drugs.
DENTAL MANAGEMENTS OF PATIENTS WITH GASTROINTESTINAL DISEASE (2).pptxSamuelAgboola11
This document discusses the dental management of patients with various gastrointestinal diseases. It begins by describing the anatomy and functions of the gastrointestinal tract. It then discusses several gastrointestinal diseases including GERD, hiatal hernia, peptic ulcer, inflammatory bowel disease (Crohn's disease and ulcerative colitis), liver cirrhosis, and eating disorders. For each condition, it describes oral manifestations that may be seen and precautions that should be taken during dental treatment. Throughout, it emphasizes the need for dentists to accommodate a patient's underlying systemic disease, avoid drug interactions, and minimize stress when providing care.
DENTAL MANAGEMENT OF PATIENTS WITH REPIRATORY DISEASES 2809-1.pptxSamuelAgboola11
This document discusses the relationship between the respiratory and oral systems. It begins by describing the structures and functions of the respiratory system, including the conducting airways, lungs, muscles of respiration, and control centers in the central nervous system. It then discusses several respiratory diseases like viral upper respiratory infections, asthma, pneumonia, and tuberculosis. For each disease, it covers signs and symptoms, pathogenesis, and dental management considerations. The document emphasizes the importance of oral health in preventing respiratory infections and managing patients with respiratory diseases.
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This document discusses the etiology, classification, and treatment of hypertension. It begins by explaining that the cause of essential or primary hypertension is unknown in most cases, while secondary hypertension has an identifiable cause. It then covers the classification of hypertension by blood pressure levels. The rest of the document details the mechanisms regulating blood pressure, various classes of antihypertensive drugs including diuretics, ACE inhibitors, ARBs, beta blockers, and calcium channel blockers, and guidelines for treating different stages of hypertension.
The urinary system drugs document discusses several classes of drugs used to treat conditions of the urinary system. It begins by describing the anatomy and physiology of the urinary system and its functions of regulating blood volume, waste removal, and urine formation. It then discusses several classes of diuretic drugs that increase urine production including thiazides, loop diuretics, potassium-sparing diuretics, and carbonic anhydrase inhibitors. It also discusses drugs that lower blood pressure such as ACE inhibitors, calcium channel blockers, and beta-blockers. The document concludes by covering treatments for conditions like urolithiasis, urinary incontinence, and overactive bladder.
This document summarizes various classes of antihypertensive drugs. It discusses how diuretics like thiazide and loop diuretics work to reduce blood pressure by increasing sodium excretion. It also covers ACE inhibitors which work by inhibiting angiotensin-converting enzyme and blocking vasoconstriction and sodium retention. Angiotensin receptor blockers produce similar effects. Other classes discussed include beta blockers, alpha blockers, direct renin inhibitors, calcium channel blockers, and central sympatholytics. Specific drugs within each class are provided along with their mechanisms and uses for treating hypertension.
The document discusses several classes of drugs used to treat cardiovascular conditions. It describes the mechanisms of calcium channel blockers, diuretics, vasodilators, cardiac glycosides, alpha blockers, beta blockers, ACE inhibitors, and ARBs. Calcium channel blockers work by blocking calcium entry into cells to decrease contraction. Diuretics reduce fluid volume to decrease preload and workload on the heart. ACE inhibitors block angiotensin conversion to lower blood pressure.
Heart failure occurs when the heart is unable to pump enough blood to meet the body's needs. It has a high mortality rate. The most common cause is coronary artery disease. When the heart does not contract well, blood backs up in the lungs and periphery. Chronic activation of compensatory mechanisms like the sympathetic nervous system contributes to cardiac remodeling over time.
Right heart failure causes issues like leg swelling and liver enlargement due to blood backing up. Left heart failure can cause pulmonary edema. Treatment focuses on reducing symptoms, slowing disease progression, and improving survival through drugs that target the renin-angiotensin-aldosterone system, beta-blockers, diuretics, and vasodilators. Dentists
This document discusses hypertension and classifications of blood pressure. It then summarizes various categories of antihypertensive agents including their mechanisms of action, examples of medications, therapeutic uses, and side effects. Nursing implications are provided around monitoring blood pressure during therapy, ensuring proper administration of medications, and lifestyle education to support treatment.
This document discusses several classes of cardiovascular drugs including:
- Antihypertensive drugs such as ACE inhibitors, ARBs, beta-blockers, calcium channel blockers, and diuretics which are used to treat high blood pressure.
- Beta-blockers which reduce blood pressure by blocking epinephrine and causing the heart to beat more slowly. They are used for heart disease, hypertension, arrhythmias, and other conditions.
- Loop diuretics which are used to treat fluid overload conditions.
- Vasodilators which open blood vessels to improve blood flow by relaxing vessel walls.
- Antiarrhythmic drugs which treat abnormal heart rhythms by modifying the heart
This document provides information about ACE inhibitors, which are a class of drugs used to treat hypertension. It begins by defining hypertension and describing antihypertensive drugs. It then focuses on ACE inhibitors, explaining their mechanism of action in blocking the conversion of angiotensin I to angiotensin II, thereby reducing vasoconstriction and sodium retention. The document outlines the therapeutic uses of ACE inhibitors for conditions like heart failure and kidney disease, and discusses potential adverse effects like cough, hypotension, and hyperkalemia. It concludes by listing contraindications like previous angioedema or hypersensitivity to ACE inhibitors.
This document discusses antihypertensive agents used to treat hypertension. It describes different categories of agents including adrenergic agents, ACE inhibitors, angiotensin II receptor blockers, calcium channel blockers, diuretics, and vasodilators. For each category, it covers mechanisms of action, examples of medications, therapeutic uses, and potential side effects. It emphasizes the importance of monitoring blood pressure during therapy and avoiding abruptly stopping medications.
This document discusses antihypertensive agents used to treat hypertension. It describes different categories of agents including adrenergic agents, ACE inhibitors, angiotensin II receptor blockers, calcium channel blockers, diuretics, and vasodilators. For each category, the document outlines mechanisms of action, examples of medications, therapeutic uses, and potential side effects. It emphasizes the importance of monitoring blood pressure during therapy and avoiding abruptly stopping medications.
This document discusses various classes of drugs used to treat hypertension, including their mechanisms and side effects. It describes how diuretics, ACE inhibitors, calcium channel blockers, alpha/beta blockers, and other classes work to lower blood pressure by relaxing blood vessels, reducing fluid retention, or inhibiting hormone systems like renin-angiotensin-aldosterone. Common side effects across drug classes include low blood pressure, dizziness, fatigue, and electrolyte imbalances. Regular monitoring is important when taking antihypertensive medications.
The document discusses the regulation of blood pressure and hypertension. It defines normal blood pressure and hypertension. The causes of primary and secondary hypertension are described. The pathophysiology involves the baroreflex and renin-angiotensin-aldosterone system. Treatment includes non-pharmacological methods as well as various classes of antihypertensive drugs such as ACE inhibitors, calcium channel blockers, diuretics, and beta blockers. The mechanisms of action, uses, and side effects of these drug classes are explained in detail.
1. The document discusses antihypertensive drugs, their mechanisms of action, and treatment of hypertension. It covers major classes of antihypertensive drugs including diuretics, ACE inhibitors, angiotensin receptor blockers, beta blockers, calcium channel blockers, and vasodilators.
2. It provides details on how each drug class lowers blood pressure by reducing peripheral vascular resistance, cardiac output, or sodium retention. Common side effects and advantages are also summarized for each drug class.
3. Guidelines for treating different stages of hypertension are presented, including recommendations to start with monotherapy or 2-drug combinations depending on severity, and to follow an A-B-C-D approach
This document discusses various classes of antihypertensive agents including: diuretics, beta blockers, calcium channel blockers, ACE inhibitors, angiotensin receptor blockers, and direct arterial vasodilators. It provides details on the mechanisms of action, indications, side effects and contraindications of each class. The document was submitted by Md.Moshiur Rahman from Gono Bishwabidyalay as an assignment on antihypertensive agents to his lecturer Mst. Rozina Parul.
This document provides guidelines for combination therapy for hypertension. It begins by classifying blood pressure and outlining initial drug therapy options for different BP levels, with or without compelling indications. It recommends thiazide-type diuretics, ACE inhibitors, ARBs, beta-blockers, or calcium channel blockers. The document then discusses reasons for treatment unresponsiveness and inadequate control, and provides support for combination therapy to control BP for 48-51% of patients. It outlines recommended two-drug combination therapies and cautions about their initial use.
1. Drugs Hypertesnion, heart failure and arryhthmia.pptxweldat1
This document discusses drug therapy for hypertension. It begins by defining hypertension and classifying blood pressure readings. Lifestyle modifications that can help control hypertension are described, including weight loss, reducing salt intake, moderating alcohol, and exercise. Pharmacological treatments are then outlined, with diuretics being the first-line treatment. The document focuses on different classes of diuretics including thiazides, loop diuretics, and potassium-sparing diuretics. Adverse effects of diuretics like hypokalemia are also covered.
This document discusses hypertension (high blood pressure) including its causes, mechanisms of blood pressure control, and antihypertensive drug treatments. It describes how hypertension is defined and its prevalence. It explains the roles of the baroreceptor and renin-angiotensin-aldosterone systems in long-term and short-term blood pressure regulation. Finally, it provides details on major classes of antihypertensive drugs including diuretics, beta blockers, ACE inhibitors, angiotensin receptor blockers, calcium channel blockers, and others.
This document discusses cardiovascular drugs used to treat various conditions. It covers drugs that affect the renin-angiotensin-aldosterone system like ACE inhibitors and ARBs to treat hypertension. It also discusses calcium channel blockers, beta blockers, and diuretics for hypertension. For angina, it outlines organic nitrates, beta blockers, and calcium antagonists. Antiarrhythmic drugs are broken down by class. Drugs to treat heart failure include digitalis compounds, diuretics, ionotropic drugs, vasodilators, and beta blockers.
This document discusses various classes of antihypertensive drugs used to treat hypertension. It describes the mechanisms of action, effects, and side effects of different classes including diuretics, ACE inhibitors, angiotensin receptor blockers, direct renin inhibitors, beta blockers, and calcium channel blockers. Diuretics work by increasing sodium excretion while ACE inhibitors and angiotensin receptor blockers block the renin-angiotensin-aldosterone system. Beta blockers inhibit sympathetic stimulation to lower blood pressure. Each class lowers blood pressure through different mechanisms in the body.
Antihypertensive drugs and hypertension managementAnas Indabawa
This document discusses antihypertensive drugs and hypertension management. It begins with an introduction to hypertension and outlines types of hypertension like primary or essential hypertension. It then discusses risk factors, diagnosis, and management of hypertension including both non-pharmacological lifestyle changes and various classes of pharmacological treatments. Specific drug classes are explained like ACE inhibitors, calcium channel blockers, diuretics, and others. The document also covers hypertension during pregnancy and hypertensive emergencies. It concludes with precautions for using antihypertensive drugs.
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2. Arterial Blood Pressure
• Force or tension of blood pressing against the artery walls is known as
Blood pressure
• BP is brought about by Contraction of the left ventricle, systemic
vascular resistance, elasticity of the arterial walls as well as blood
volume
• i.e. blood pressure is simply a product of cardiac output and
systemic vascular resistance
• There are a couple of major systems involved in blood pressure
regulation.
3. ANTI-HYPERTENSIVE AGENTS
ALPHA1 ADRENERGIC RECEPTOR BLOCKERS
BETAADRENERGIC RECEPTOR BLOCKERS (Selective and
Non-selective)
CENTRALLY ACTING ADRENERGIC DRUGS
CALCIUM CHANNEL BLOCKERS (Dihydropyridines and Non-
Dihydropyridines)
DIURETICS (Loop Diuretics, Thiazide Diuretics and Potassium-
sparing Diuretics)
AGENTS ACTING ON RENIN-ANGIOTENSIN-ALDOSTERONE
SYSTEM
OTHERS
4. Alpha-1 blockers e.g. Doxazosin and Prazosin
Beta Blockers
a) Selective Beta blockers: Atenolol and Metoprolol
a) Non-Selective Beta- blockers such as Labetalol and Carvedilol
5. Centrally acting adrenergic drugs which work by
blocking sympathetic activity within the brain e.g.
Clonidine and Methyldopa
6. Calcium Channel Blockers
These are divided into two main sub-classes
Dihydropyridines and Non-Dihydropyridines
Dihydropyridines selectively inhibit L-type Calcium
channels in the vascular smooth muscle
Non-Dihydropyridines which are non-selective
7. Diuretics
There are 3 major classes of diuretics that are used in the treatment of
hypertension.
Loop Diuretics
Thiazide Diuretics
Potassium-Sparing Diuretics
9. RAAS Agents
Agents that work on Renin-Angiotensin-Aldosterone System include
• Renin
• Angiotensin Converting Enzyme Inhibitors
• Angiotensin II Receptors Type I or AT1 Receptors Inhibitors
10. RAAS Agents Contd
Agents that work on Renin-Angiotensin-Aldosterone System include
• Renin
• Angiotensin Converting Enzyme Inhibitors
• Angiotensin II Receptors Type I or AT, Receptors Inhibitors
11. Other Anti-Hypertensive Agents
Other anti-hypertensive agents, that do not fall into any of the classes
discussed above
o Bosentan
oFenoldopam
oSodium nitroprusside and Nitroglycerin
12. Other Anti-Hypertensive Agents Contd
Other anti-hypertensive agents, that do not fall into any of the classes
discussed above
o Bosentan
oFenoldopam
oSodium nitroprusside and Nitroglycerin
13. Other Anti-Hypertensive Agents Contd
Other anti-hypertensive agents, that do not fall into any of the classes
discussed above
o Bosentan
oFenoldopam
oSodium Nitroprusside and Nitroglycerin
14. Direct Acting Smooth Muscle Relaxant
Drugs e.g. Hydralazine and Minoxidil
Hydralazine, direct-acting smooth muscle relaxant.
Hydralazine mechanism of action not entirely determined
yet.
Minoxidil stimulates smooth muscle ATP-activated
potassium channels opening for membrane stabilization.
Editor's Notes
Arterial blood pressure is regulated by pressure sensitive neurons called baroreceptors located in the aortic arch and carotid sinuses.
If the blood pressure falls too low, those baroreceptors can send signals to the adrenal medulla, causing release of catecholamines and thus increase in sympathetic activity through activation of α and β receptors. So activation of β1 receptors causes increase in the heart rate and stroke volume and thus increased cardiac output which leads to the increase in blood pressure.
On the other hand, activation of α1 receptors on the smooth muscle causes vasoconstriction and thus increase in vascular resistance which again leads to increase in blood pressure.
Alpha-1 blockers block alpha-1 receptors in the smooth muscle thus causing decrease in systemic vascular resistance and ultimately decrease in blood pressure e.g. Doxazosin and Prazosin.
Selective Beta blockers: Atenolol and Metoprolol which selectively block beta-1 receptors on the heart thus causing decrease in cardiac output and thereby decrease in blood pressure.
Non Selective Beta-blockers such as Labetalol and Carvedilol that can additionally block alpha-1 receptors and thus simultaneously decrease vascular resistance. Furthermore, beta blockers can inhibit beta-1 receptors present in the kidney and thus suppress release of renin, formation of angiotensin II and secretion of aldosterone. So these effects result in decrease in systemic vascular resistance and again fall in blood pressure.
This works by blocking sympathetic activity within the brain e.g. Clonidine and Methyldopa.
Clonidine selectively stimulates presynaptic alpha-2 receptors thus providing a negative feedback to reduce catecholamine production and release which leads to decrease in systemic vascular resistance and cardiac output and ultimately decreased blood pressure.
Methyldopa on the other hand also lowers blood pressure through the same mechanism. However, unlike clonidine it is not active on itself, so first it must be converted to its active metabolite called methyl norepinephrine to produce its effect.
Dihydropyridines inhibit L-type calcium channels in the vascular smooth muscle. Under normal conditions when calcium enters the smooth muscle cell, it causes it to contract which leads to increased vascular resistance and thus increase in blood pressure. So when dihydropyridine drug blocks the entry of calcium into the vascular smooth muscle cell, the contraction is inhibited which leads to decreased resistance to blood flow and thus lowering of blood pressure. Examples of drugs that belong to this group are Amlodipine, Felodipine, Nicardipine and Nifedipine. Side effects of Dihydropyridines are related to systemic vasodilation i.e. dizziness, headache, flushing and peripheral oedema, swelling of gums, also known as gingival hyperplasia.
Non-dihydropyridines: They are non-selective inhibitors of L-type calcium channels. In other words, they are not only capable of blocking calcium channels on vascular smooth muscle but also calcium channels on cardiac cells such as those of SA node and AV node which leads to reduced myocardial contractility, slower heart rate and slower conduction. That is why these agents exhibit significant anti-arrhythmic properties. Though decreased heart contractions will typically result in decreased cardiac output, non-dihydropyridines do not significantly decrease cardiac output most likely because of the reflex tachycardia that occurs as a result of vasodilation e.g. of drugs belonging to this class of drugs are Diltiazem and Verapamil.
Side effects of these agents include excessive bradycardia and cardiac conduction abnormalities.
Also, verapamil which happens to be the least selective calcium channel blocker can exert significant inhibition of calcium channels in the smooth muscle that lines the gastro-intestinal tract which can lead to constipation.
Loop Diuretics: Furosemide works by reducing reabsorption of sodium chloride in the kidney leading to significant diuresis.
With less volume in the vascular space less blood returns to the heart so cardiac output reduces. This in turn leads to decrease in blood pressure, particularly, in the patients with volume-based hypertension and Chronic Kidney Disease(CKD).
Thiazide Diuretics: Hydrochlorothiazide, which also reduces reabsorption of sodium chloride in the kidneys, but to a much smaller degree than loop diuretics. This leads to initial decrease in the intravascular volume, decrease in cardiac output and ultimately lower blood pressure. However, the long term effects on blood volume are minimal and sustained anti-hypertensive effects are thought to be produced by thiazide-induced vasodilation.
Potassium-Sparing Diuretics such as Triamterene and Spironoloratone which increase diuresis by either interfering with the sodium-potassium exchange in the kidneys or by blocking the actions of aldosterone.
Potassium-sparing diuretics are often used in combination with loop and thiazide diuretics to reduce loss of potassium, that occur with the use of these drugs.
Agents that work on Renin-Angiotensin-Aldosterone System (RAAS). There are three pharmacological targets that can be used to reduce the activity of AngiotensinII, which is ultimately responsible for causing blood pressure to increase.
Renin: The enzyme responsible for the conversion of Angiotensinogen to precursor of Angiotensin II that is Angiotensin I, so renin is the target of renin inhibitors i.e. Alliskiren.
Angiotensin Converting Enzyme Inhibitors: These are the agents which inhibit the conversion of Angiotensin I to Angiotensin II. The enzyme (ACE) just like the inhibition of renin, inhibition of ACE also leads to decreased production of Angiotensin II. However, what makes ACE inhibitor different is that in addition to lowering Angiotensin II levels, they can also elevate bradykinin levels. Bradykinin is a peptide that cause blood vessels to dilate by stimulating the release of nitric oxide and prostacyclin. However, normally ACE inactivates bradykinin, so its inhibition leads to bradykinin-induced vasodilation, e.g Benazipril,Catopril, Enalapril, Lisinopril, Quinapril and Ramipril.
Angiotensin II Receptors Type I or AT, Receptors Inhibitors; Binding of Angiotensin II to these receptors is actually responsible for most of the effects of Angiotensin II, including vasoconstriction and stimulation of aldosterone release.
These receptors are the targets of Angiotensin II receptor blockers or ARB i.e Cadensartan, Irbesartan, Losartan, Olmesartan and Valsartan.
In summary, the agents that work on RAAS either block the production of Angiotensin II or block its actions on the AT Receptors. These in turn leads to decreased systemic vascular resistance but without significant changes in cardiac output.
Additionally, these agents reduce the effects of Angiotensin II on renal hemodynamics.
Specially, Angiotensin II constricts the efferent arteriole, thereby, generating back pressure in the glomerulus which can lead to injury. So by reducing the activity of Angiotensin II, these agents also renal-blood flow and thereby reduce the risk of renal injury.
Side Effects: Because the agents suppress aldosterone release, their use can contribute to development of hyperkalemia. Furthermore, ACE inhibitors in particular, may cause dry cough or in rare cases, Angioedema, which can be life threatening.
This is thought to be due to increased levels of bradykinin and substance P.
Bosentan: It is a competitive antagonist of a potent vasoconstrictor called Endothelin I which acts on Endothelin A and Endothelin B receptors located on pulmonary vascular cells. By blocking the action of Endothelin I on these receptors, Bosentan leads to vasodilation which decreases pulmonary vascular resistance; for that reason Bosentan is often a drug of choice for treatment of pulmonary hypertension.
Fenoldopam: It is a selective dopamine I receptor agonist, the dopamine I receptors are located on the smooth muscle cells in the peripheral vasculature as well as the renal coronary cerebral and mesenteric arteries. By stimulating dopamine-I receptor.
Fenoldopam produces generalized arterial vasodilation which leads to decreased peripheral resistance and thus lower blood pressure. Additionally, Fenoldopam inhibits tubular sodium reabsorption, which results in natriuresis and diuresis. Due to its rapid onset of action, and short duration of action, Fenoldopam is used in the Hospitals for short term management of severe hypertension.
Sodium Nitroprusside and Nitroglycerin: They serve as a source of nitric oxide (NO) a potent peripheral vasodilator.
Minoxidil, works by stimulating opening of ATP-activated potassium channels, in the smooth muscle leading to memebrane stabilization. This makes vasoconstriction less likely.
While these agents significantly decrease peripheral resistance, they also produce significant compensatory reflex tachycardia and renin release, therefore these drugs are typically administered in combination with a diuretic and a beta-blocker.
N.B: Topical application of minoxidil promotes hair growth, hence it is used in the treatment of baldness.