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33-35 Anti-Hypertensive Drugs Katie (Sympatholytics (Beta-Blockers (Non…
33-35
Anti-Hypertensive Drugs
Katie
Oral Diuretics
Anti-Htn doses are much lower
than those for diuresis
(avoid side effects)
FIRST CHOICE:
Thiazides
African American
Elderly
Severe cases, renal insufficiency, HF
Loop Diuretics
To Decrease K Loss:
K Sparing + Hydrochlorothiazide + Loop Diuretic
Sympatholytics
Centrally Acting
Alpha-2 Agonists
Clonidine
Methydopa
Alpha-1 Adrenergic Blockers
Prazosin
Doxazosin
Terazosin
Beta-Blockers
Non-Specific
Propranolol
Timolol
Nadolol
Cardio-Specific / B1-Blockers
Metoprolol/Atenolol/Nebivolol
Acebutolol
Bisoprolol
B-Blockers with Intrinisic Sympathetic Activity
Pindolol
Acebutolol
Penbutolo
Alprenolol
Oxprenolol
Combined
Alpha & Beta Blockers
Carvedilol
Labetalol
Ganglion Blocking Agents
NONE ON MARKET
Mecamylamine (tx: Tourette's)
Trimethapham
Adrenergic Neuron Blocking Agents
Guanethidine (replaces NE in vesicle, inhibits exocytosis;
not available
)
Reserpine
(inhibits NE into vesicle > NE metabolized by MAO; bad side effects)
Na retention, so use w/ diuretic
Direct Vasodialtors
Via NO
Hydralazine (oral,
arterioles
only)
Sodium Nitropursside (IV)
Via Opening K Channels
Minoxidil (oral,
arterioles
only, toxicity = hypertrichosis )
Diazoxide (IV; ATP-sens K channels active)
D1 Receptor Stimulant
Fenoldopam (IV)
Calcium Channel Blocker
Verapamil (strongest cardiac effect; constipation)
Diltiazem
all "-dipine" (7)
Angiotensin Inhibitors
ACE Inhibitors
"-pril" Drugs
Angiotensin Receptor Blocker
(Blocks
AT1
Receptor on arterioles)
"-sartan" Drugs
Renin Inhibitor
Aliskiren
enhances effect of one another
Combination BP Lowering Drug
Polypill
Telmisartan
Amlodipine
Chlorthalidone
(one low-dose pill for BP control)
Oral = chronic hypertension
IV = Hypertensive emergencies