Hypertensive Drugs

Clonidine

A2 receptor Agonists
Used for prophylaxis against migraine headaches and treatment of severe dysmenorrhea and menpausal flushing-do not discontinue abruptly

Guanfacine

A2 receptor Agonist

Methyldopa

A2 receptor Agonist

Reduces sympatyhetic flow; clack of norepinephrine reduces B/P and rennin in the kidney

A2 receptor agonist

Hypotensive effect is severe enout to cause the pt to lose consciousness with even the first dose

First dose syndrome

Doxazosin (Cardura)

A1 Receptor Blocker

Prazosin (Minipress)

A1 Recptor Blocker
Oldest Reduces Peripheral vascular resistance and B/P by dilating both arterial and venouse blood vessels

Terazosin (Hytrin)

A1 Receptor Blocker
Can reduce hematocrit

Tamsulosin (Flomax)

A1 Receptor Blocker
Not used in contol--used soley for symptomatic control of B/P

Block A1 adrenergic receptros which when stimulated by circulating norephinephrine produce increade by thus when they are blocked bp is decreased Also used with severe HF with cardiac glycosides and diuretics

A1 Receptor blockers

Atenolol

B-Blocker

Propranolol

B-Blocker

Cardioselective

B-1 receptor Blocker

Nonselective

B1 and B2 blocker

Cause a reduction in the secretion of rennin which in turn reduces bot AII mediated vasocontrictino and aldosterone mediated volume expansion

B-Blockers

Labetalol

Dual A1 and B receptor Blockers

Carvedilol (coreg)

Dual A1 and B receptor Blockers
Do not use with asthma, cardiogenic shock, severe bradycardia used for moderate HF with digoxin diuretics and ACE inhibitors

Dual antihypertensive effects of reduction in heart failure (B1 Receptor) and vasodialation (A1 receptor blockade)

Dual A1 and B receptor Blockers

Captopril (Capoten)

ACE Inhibitor
shortest 1/2 life
Not a prodrug

Benzepril (Lotensin)

ACE Inhibitor

Enalapril (vasotec)

ACE Inhibitor

Fosinopril (Menopril)

ACE Inhibitor

Lisinopril (Prinivil Zestril)

ACE Inhibitor
Not a prodrug

Moexipril (Univasc)

ACE Inhibitor

Perinodopril (Aceon)

ACE Inhibitor

Quinapril (Accupril)

ACE Inhibitor

First line in hypertension and HF
Many used with a diuretic or CCB
Decrease afterload and SVR and preload
PREVENT Sodium and Water resorption by inhibiting aldosterone secretion

ACE inhibitor

Ramipril (Altace

ACE Inhibitor

Trandolapril (Mavik)

ACE Inhibitor

Losartan (Cozaar, Hyzaar)

Angiotensin II Receptor Blocker

Block vasocontriction and secretion of aldosterone..decrease SVR...used in pt who cannot tolerate ACE inhibitors--DO NOT CAUSE COUGH

Angiotensin II Receptor Blockers

Benzothiazepines

Calcium Channel Blockers

Dihydropyridines

Calcium Channel Blockers

Phenylalkylamines

Calcium Channel Blocker

Primary for hypertension and angina-Cause smooth muscle relaxation by blocking the binding of calcium to its receptros which prevents contraction.

Calcium Channel Blocker

Decreases plasma and extra cellular fluid volumes which results in decreased preload leading to decreased cardiac output and total peripheral resistance--accelerates the rate of urine formation

Diuretics

Very potent-renal, cardiovascular and metabolic effects, act along the Loop of Henle blocking chloride and sodium reabsorption-rapid onset

Loop Diuretics

Bumetanide

Loop Diuretic

Ethacrynic Acid

Loop Diuretic

Furosemide (Lasix)

Loop Diuretic
Most commonly used in pulmonary edema and edema associated with HF, Liver disease, Nephritic syndrome, and ascites

Torsemide

Loop Diuretic

Chemilcal derivatives for sulfonamide antibiotices

Carbonic Anhydrase Inhibitors

Block aldosterone receptorts

Potassium Sparing Diuretics

Amiloride

Potassium Sparing Diuretics

Spironolactone

Potassium Sparing Diuretics

Triamterene

Potassium Sparing Diuretics

Act directly on vascular smooth muscle cells causing relaxation, not through an A or B receptor. Directly elicit peripheral vasodilation reducing SVR

Vasodilators

good for black pts. Used in emergency situations because of injectable form

BiDil
Diazoide
Vasodialator

Hydralazine

Vasodialator

Minoxidil

Vasodialator
T-Wave electrocardiographic changes

Sodium Nitroprusside

Vasodialator...most common

Cardiac Output x Peripheral resistance

Blood Pressure

Heart Rate x Stroke Volume

Cardiac Output