Professional Documents
Culture Documents
Drugs Affecting Blood Pressure
Drugs Affecting Blood Pressure
Blood Pressure
• Elements
– Heart Rate
– Stroke Volume
– Peripheral Vascular
Resistance
• Baroreceptors
• Renin-Angiotensin System
Hypertension
Stage 1 140-159 90-99
Stage 2 160-169 100-109
Stage 3 180-209 110-119
Stage 4 210 120
Secondary Hypertension
• Cause is known (such as eclampsia of pregnancy,
renal artery disease, pheochromocytoma)
• 10% of the cases
• Hypotensive states:
– Heart muscle is damaged
• CO = Cardiac output
• SVR = Systemic vascular resistance
Adrenergic Agents
Alpha1 Blockers
• doxazosin (Cardura)
• prazosin (Minipress)
• terazosin (Hytrin)
Adrenergic Agents
Central-Acting Adrenergics
• clonidine (Catapres)
• methyldopa (Aldomet)
(drug of choice for hypertension in pregnancy)
Adrenergic Agents
Adrenergic Neuronal Blockers
(peripherally acting)
• reserpine
• guanadrel (Hylorel)
• guanethidine (Ismelin)
• Therefore, increased BP
Copyright © 2002, 1998, Elsevier Science (USA). All rights reserved.
Antihypertensive Agents:
Mechanism of Action
ACE Inhibitors
• Aldosterone stimulates water and sodium resorption.
• Result: increased blood volume, increased preload,
and increased B
• Phenylalkamines:
– verapamil (Calan, Isoptin)
• Dihydropyridines:
– amlodipine (Norvasc), bepridil (Vascor),
nicardipine (Cardene)
– nifedipine (Procardia), nimodipine (Nimotop)
Copyright © 2002, 1998, Elsevier Science (USA). All rights reserved.
Antihypertensive Agents:
Therapeutic Uses
Calcium Channel Blockers
• Angina
• Hypertension
• Dysrhythmias
• Migraine headaches
• Gastrointestinal
– constipation, nausea
• Other
– rash, flushing, peripheral edema, dermatitis
Vasodilators
• diazoxide (Hyperstat)
• hydralazine HCl (Apresoline)
• minoxidil (Loniten, Rogaine)
• sodium nitroprusside (Nipride, Nitropress)
• Sodium nitroprusside:
– bradycardia, hypotension, possible
cyanide toxicity