Antihypertensive agents. Hypertension :. Antihypertensive agents - Rationale. Long-term goal of antihypertensive therapy: Reduce mortality due to hypertension-induced disease Stroke Congestive heart failure Coronary artery disease Nephropathy Peripheral artery disease Retinopathy.
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Long-term goal of antihypertensive therapy:
Reduce mortality due to hypertension-induced disease
Typical Diurnal Blood Pressure Rhythm in a "Dipper"
Paradigms of Antihypertensive
Classification of antihypertensives :
-Arterial (hydralazine, minoxidil, fenoldopam)
-Arterial and venous (Nitroprusside)
Thiazides or thiazides like diuretics:
Angiotensin Converting Enzyme (ACE) Inhibitors:
Indications for ACE inhibitors includes:
In bilateral renal artery stenosis and renovascular hypertension, glomerular filtration pressures are maintained by vasoconstriction of the efferent areteiole (post-glomerular arterioles), an effect mediated by angiotensin II.
ANGIOTENSIN RECEPTOR BLOCKERS ARBs (AT 1 BLOCKERS):
Losartan, Erbesartan, Candesartan
Antihypertensives agents agents
RENIN INHIBITORS: Aliskiren:
BETA BLOCKERS: Mechanism of action:
Guidelines for the use of Beta-Blockers in Hypertension
a) hyperkinetic essential hypertension (associated high levels of catecholamines)
b) hypertrophic obstructive cardiomyopathy.
c) exertional angina.
c) post myocardial infarction.
d) hypertensive emergency (labetalol).
REDUCING SYMPATHETIC OUTFLOW FROM CNS:
CALCIUM CHANNELS BLOCKERS : CCB
Types of calcium channels : L, N, T
Sodium nitroprusside (SNP):
Hydralazine : Adverse effects
Hydralazine : Uses
Effects of Minoxidil
Rationale for use of 1. Diuretics and 2. Beta blockers along with vasodilators.
Hypertensive emergencies :
THE CHOICE OF THE ANTIHYPERTENSIVE IN PATIENTS WITH CONCOMITANT DISEASES.