:/
Antihypertensive Drugs
132-33 :
-
TREATMENT
HTN
for
-
{
cholesterol
management ( NaCl d. call,
diet
t
)
exercise 1 weight loss
etc .com/smoking
I
management )
treatment
Pharmacological
Lsympatholytic drugs
LACEI
( Diuretics
( vasodilators
( ARB
LCCB
÷÷÷÷i÷÷÷÷÷i÷i÷÷i÷÷÷: ÷ ÷ ÷i÷ ÷ ÷ ÷ i:
&
Epirote.te)
vasodilators
in severe HEN
inhibit aldosterone
inhibit Nat flux
SIDE EFFECT
( Hyperglycemia
(
µyperql
Hyper lipidemia
( Hyponatremia
(
( Allergic
•
( ( (up
reaction
calcium
ne
"
Hypercalcemia
L combine
↳
a
(
-
Henatypertensive emergency
metabolized by acetylation
POLYMORPHISM
LSE
slow
↳ rapid
palpitation
reflex tachycardia & sympathetic stimulation
develop lupus erythematosus like syndrome
headache, nausea, anorexia
:
acetylatorsttydralazined
acetylates
→
Hydrazines
,
provoke anginal arrhythmias
-
•
SNP : sodium
nitro prussiate
't:÷÷i÷÷÷÷:÷:÷÷÷÷÷÷÷÷: ÷i÷÷÷÷÷:: ÷:
""
4.ACEI:AngiotensinConvertingEnzymeInhibit
•
l inhibit ACE
to
,
b
-
SE:
hypotension renal
to Drug interaction
(
clinical
(
receptor antagonists
central acting agent
thatapril
from changing angiotensin I
angiotensin I
( vasoconstriction
d. Bpd aldosterone secretion d
↳ block bradykinin breakdown vasodilation
adrenergic receptor antagonists
-
with diuretics If blocker
( resistance
glycemic
2.gympaf.gg/yf,#I.Bm-iadrean&er9pi
c
↳
minoxidil )
( nitroprusside, nitroglycerine )
Hydralazine
hyperuricemia
metabolic alkalosis &
Hypokalemia ,
(
Arteriolar dilators ( Hydrazine ,
↳ Arteriolar & venolar dilators
treatment ( lifestyle modification )
Noenspthrearsmaegioeloggical
-
3.Vasodilato&
I
,
K
:
-
failure hyperkalemia dry cough angioedema
,
,
sparing diuretics , NSAID
↳ block
↳ hyperkalemia
use
,
bradykinin
→
impair
effect
Hypertension IHeart failures myocardial infarction Diabetic nephropathy
contraindication : pregnant , renal
artery
stenosis,
hyperkalemia Gerd
,
5.tt/3B:Angiotensinreceptorblockingagent#o1stGEN
)
zip adrenergic
moss byliner
-
,
HRT , conduction b. contractility
I :}
Bronchospasm,
,
•
propranolol hadolol , Sota lol
(
nonselective
:
2nd GEN
Peripheral
selective Bi (
:
vasoconstriction
atenolobmetrop.ro/o1.bisorolol,esmo1o1 )
i'sina.in.w.aiiii.iiii.ie:
"
( p -12
(B
-
SE :
nitric oxide
+
,
CNS ,
( hebivolol )
hypotension , bradycardia libido , HDL b. Tag
,
AVOID : Asthma IDM
adrenergic ( prazosin
selectively
effect
ono
( not
on
doxazosin
)
receptor > smooth muscle relaxation
↳ Bpd ,
presynaptic 22
dilation
reflux
is
SE :
,
HTN
binda , > block NE
promote
• veno
2.3
patient
Rebound
WITHDRAWAL
2.2 d-
""
( Iabetalol , carved , lol )
,
•
"
"
NE
>
release )
cardiac
preload
f
t
tachycardia d
postural HTN
,
first dose
phenomenon
+
sympathetic
postural
(
past excrete
sedation dry mouth
7- St
( se
.
:
first
,
,
,
outflow
via
d
→
HRD
kidney The
mental
cough
& angioedema
)
dittiazem
&
heat &
Dihydro pyridine
(
-
CDHPS )
,
,
used
cardio depression
AV block
amlodipine
Hypertension
-
headache
cardiodepression
[ AV block
SBP
DBP
-
420
480
D
OPTIMAL
0
NORMAL
120-129
80-84
SEVERE
7180
2110
A
-1
bmost
peripheral edema
l ggensatdipaeahtieon
ldittiazem
,
felodipine, nicardipinqnisodipine)
vessels
selective to blood vessels
sfjerhaypappontie(nsioh
/
severe HTN
CLONIDINE
Laz agonist → sympathetic
metabolism
to ACEI ( except
.at#n :.asonists/: n:i s: : i: o:i s: l: :
HTN
pregnancy + HTH ,
:
(
Verapamil
( affect
depressed baroreceptor
:÷÷÷÷÷÷÷÷÷÷÷÷÷÷:÷÷÷÷:÷÷
use
(
'
prostatitis >hyperplasia
outflow b ( vaso pressor center in brainstem
)
"
Clinical
bradykinin
on
:÷÷÷÷:::::u÷::;mein÷÷÷÷÷: ÷÷:÷÷÷÷i÷÷÷÷÷÷÷÷÷:
↳ treat Benign
-Itagaent
Knifed'aPIfPe"Tiatesitude
,
b less
flow 9
( no
( St effect
similar
hypotension
Centrally acting agent ( Methyl dopa Clonidine )
•
urine
Losartan , Irbesartan
•
Vessel relax
wishbones
8-12 hr
depression
,
withdrawal life threatening !
-_
( HTN crisis )
6290040nF
)
633070347
-
9