Antihypertensive drugs

Blood pressure over >140/90

• CO x TPR
• cardiac output(CO) and Total physical response of arterioles/postcapillary venues/ heart

• diuretics*
• angiotensin inhibitors (ACE - I and ARB)*
• Beta Blockers
• Centrally acting sympatholytics
• peripherally acting sympatholytic
• Ca2+ channel blockers*
• Orally active vasodilators

• Thiazides
• Loop Diuretics
• K+ Sparing

cause Na+ excretion and reduce fluid volume by inhibiting electrolyte transport in the renal tubules

Transport by thick ascending limb cells. Model for ion transport by thick ascending limb. this segment, also referred to as the diluting segment, is impermeable to water, and thus the tubular lumen concentration of ions decreases

Transport by distal convoluted tubule cells. Model for a distal convoluted tubule cell. As in the case for the thick ascending limb, this segment is relatively impermeable to water

Transport by principal cells of the collecting tubule. The principal cell contains both Na+ and K+ channels in the apical cell membrane. The Na+ channel in the apical cell membrane depolarizes the membrane and provides an asymmetrical transepithelial voltage profile that favors K+ secretion

• Initial therapy for hypertension
• Initially: Increase in urinary water and electrolyte exertion, decrease in plasma volume and CO
• After several days: Normal CO and decrease in TPR

• Hypokalemia
• Dilutional Hyponatremia
• Hypomagnesemia
• Hypercalcemia with thaizide diuretics
• Hypocalcemia with loop diuretics
• Hypersensitivity

• Ace Inhibitors
• Angiotensin Receptor Blockers
• Renin Inhibitors

reversibly inhibit Ace and reduce blood pressure by inhibiting angiotensisn II formation

reversibly bind to the ATI subtype of angiotensin II receptors in blood vessels and other tissues

Raises blood pressure when blood pressure falls

• 1.Blood pressure falls
• 2. Renin converts Angiotensinogen to Angiotensin I
• 3.Angiotensin Converting Enzyme converts Angiotensin I to Angiotensin II
• 4. Angiotensin II increases blood pressure and also activates aldosterone

when patient has other risk factors such as heart failure, postmycocardial infarction, diabetes, kidney disease and stroke

dry cough, hyperkalemia, hypotension

hyperkalemia, hypotension

Inhibit the inward movement of Ca2+ through the L-type voltage -dependent Ca2+ channels

Cardiodepression, hypotension, headache, dizziness, peripheral edema