ppt

1. Antihypertensive Drugs
• Classification, Mechanism, Uses, and Adverse
Effects
• Your Name / Institution

2. Introduction
• • Hypertension = persistent rise in arterial
blood pressure
• • Major risk factor for stroke, MI, heart failure,
kidney disease
• • Goal: reduce morbidity & mortality by
lowering BP

3. Classification of Antihypertensives
• 1. Diuretics
• 2. Sympatholytics (β-blockers, α-blockers,
Centrally acting drugs)
• 3. Vasodilators
• 4. Calcium channel blockers
• 5. RAAS inhibitors (ACE inhibitors, ARBs, Renin
inhibitors)

4. Diuretics
• Examples: Thiazides, Loop, K⁺ sparing
• Mechanism: Promote sodium and water
excretion → ↓ blood volume → ↓ BP
• Uses: Mild–moderate hypertension
• Adverse effects: Hypokalemia, hyperuricemia,
dehydration

5. β-blockers
• Examples: Propranolol, Atenolol, Metoprolol
• Mechanism: Block β1-receptors → ↓ HR &
contractility, ↓ renin release
• Uses: Hypertension with angina, post-MI,
arrhythmias
• Adverse effects: Bradycardia, fatigue,
bronchospasm

6. α-blockers
• Examples: Prazosin, Terazosin
• Mechanism: Block α1-receptors →
vasodilation → ↓ TPR
• Uses: Resistant hypertension, BPH
• Adverse effects: Postural hypotension,
dizziness

7. Centrally Acting Drugs
• Examples: Clonidine, Methyldopa
• Mechanism: Stimulate central α2 receptors →
↓ sympathetic outflow
• Uses: Methyldopa in pregnancy hypertension
• Adverse effects: Sedation, rebound
hypertension (clonidine)

8. Vasodilators
• Examples: Hydralazine, Minoxidil
• Mechanism: Direct relaxation of vascular
smooth muscle → ↓ TPR
• Uses: Severe / resistant hypertension
• Adverse effects: Reflex tachycardia, fluid
retention, hypertrichosis (minoxidil)

9. Calcium Channel Blockers (CCBs)
• Examples: Amlodipine, Nifedipine, Verapamil,
Diltiazem
• Mechanism: Block Ca²⁺ entry → vasodilation,
↓ HR (non-DHP)
• Uses: Hypertension, angina, arrhythmias
• Adverse effects: Ankle edema, constipation,
bradycardia (non-DHP)

10. RAAS Inhibitors
• ACE Inhibitors (Enalapril, Lisinopril) – block
Ang I → Ang II
• ARBs (Losartan, Valsartan) – block Ang II AT1
receptors
• Renin Inhibitor (Aliskiren) – blocks renin
activity
• Uses: Hypertension, CHF, diabetic
nephropathy
• Adverse effects: Cough (ACEi), hyperkalemia,
angioedema

11. Combination Therapy
• Used in resistant hypertension
• Examples:
• • Diuretic + ACE inhibitor
• • β-blocker + vasodilator
• • CCB + ARB

12. Special Considerations
• Pregnancy: Methyldopa, labetalol, nifedipine
safe
• Diabetes: ACE inhibitors/ARBs preferred
• Asthma: Avoid non-selective β-blockers

13. Summary
• • Hypertension → major CV risk factor
• • Multiple drug classes with different
mechanisms
• • Choice depends on patient comorbidities
• • Monitoring of side effects is essential

14. References
• Goodman & Gilman’s Pharmacology
• Katzung’s Basic & Clinical Pharmacology
• Standard treatment guidelines