ANTI- HYPERTENSIVES
A
ACE INHIBOTORS
Zofenopril
Enalapril
Lisinopril
Captopril
Notes; - zefonopril cost- 2000 per tab, captopril is 2000 ugx per 10 tabs
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Zefonopril dosed once a day, captopril dosed 3 times a day
Side effects; - cough, swollen face, lips and tongue (usually changed to ARBS)
ARBS
Telmisartan
Losartan
Valsartan
Notes; - usually used with diuretics
-
Monitor BP and Electrolytes
Side effects – dizziness, postural hypotension (orthostatic hypotension), Hypokalemia
ALPHA BLOCKERS
Act Androgenous receptors,
Selective
Act on Alpha 1 – Doxazosin
Non selective
Act on Alpha 2 – Benzylamine
Side effects; Orthostatic hypotension, headache, fatigue, First dose syncopy
ALPHA 2 AGONISTS / CENTRAL ACTING AH
Methyldopa (safe in pregnancy)
Clonidine
Note; drug similar to clonidine but longer acting is Guanfacine.
Notes; Cases of rebound hypertension if treatment stopped abruptly. You need to tapper
medication in case treatment need to be stopped.
Side Efffects – Bradycardia
BETA BLOCKERS
Adrenaline
Selective beta 1
Bisoprolol *
Metoprolol*
Atenolol
Nebivolol
Non selective beta 1 and beta 2
Propranolol
Carvedilol*
Side effects; Bradycardia, fatigue, Insomnia ( negative feedback loop ), Cold Extremities, Diziness
Notes; - those with * are the only beta blockers used to treat Heart Failure. Others known to
worsen Heart Failure.
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Don’t give non-selective beta blockers to asthma patients . beta 1 found in heart , but
beta 2 found in lungs thus will cause broncho – constriction , thus worsening the
asthma.
Don’t give non-selective beta blockers to Diabetics as the beta blockers can hide/ mask
hypoglycaemia
CALCIUM CHANNEL BLOCKERS
a) Dihydropyridines
Act on blood vessels mainly
Nifedipine
Amlodipine
Felodipine
Cilnidipine
Nicardipine
b) Non-dihydropyridines
Act on contractility and heart rate
Diltiazem
Verapamil
Not used in treatment of heart failure but used for arrythmias, arterial fibrillation
DIURETICS
Thiazide Diuretics - DCT
First Line for hypotension
Bendroflumethiazide – works by inhibiting sodium reabsorption at the beginning of the distal
convoluted tubule.
Hydrochlorothiazide
Chlorothiazide
Loop diuretics – TAL
Furosemide
Bumetanide
Torsemide
Ethacrynic Acid
Mineral Corticoid Receptor Antagonists (k+ sparing diuretics)