Anti-hypertensives : Anti-hypertensives
Slide 2 : Drugs that are used to treat hypertention (high blood pressure)
Slide 3 : Anti-hypertensives
Slide 4 : True or False?
African Americans, Puerto Ricans and Cuban- and Mexican-Americans are more likely to suffer high blood pressure than Anglo-Americans.
People with lower educational and income levels tend to have higher levels of blood pressure
Slide 5 : True
African Americans, Puerto Ricans and Cuban- and Mexican-Americans are more likely to suffer high blood pressure than Anglo-Americans.
People with lower educational and income levels tend to have higher levels of blood pressure
Slide 6 : What is considered HTN?
Slide 7 : What is considered HTN?
systolic BP >140, Diastolic >90
Slide 8 : True or False
Sustained HTN leads to target organ damage : after about 5 years.
Slide 9 : True
Sustained HTN leads to target organ damage : after about 5 years.
Slide 10 : What is considered Normal range for BP?
Slide 11 : What is considered Normal range for BP?
Normal : Systolic/Diastolic =
< 130/< 85
Identify which Stage : Identify which Stage Match Stage 1, 2, and 3:
140 - 159
90 – 99
160 - 179
100 -109
> 180
> 110
Identify which Stage : Identify which Stage Hypertension - Stage 1
140 - 159
90 – 99
Stage 2
160 - 179
100 -109
Stage 3
> 180
> 110
Slide 14 : Match correctly
Regulation of BP
Short term : ___________
Long term : ___________
A. Baroreceptors B. RAS (RAAS)
Slide 15 : Match correctly
Regulation of BP
Short term : Baroreceptors
Long term : RAS (RAAS)
Slide 16 : True or False
RAS or the renin-angiotensin-aldosterone system (RAAS) is a hormone system that regulates blood pressure and water/fluid balance
Slide 17 : True
RAS or the renin-angiotensin-aldosterone system (RAAS) is a hormone system that regulates blood pressure and water/fluid balance
Slide 18 : True or False
When blood volume/blood flow is low the kidneys secrete renin.
Renin stimulates the production of angiotensin.
Angiotensin causes blood vessels to constrict resulting in increased blood pressure.
Slide 19 : True
When blood volume/blood flow is low the kidneys secrete renin.
Renin stimulates the production of angiotensin.
Angiotensin causes blood vessels to constrict resulting in increased blood pressure.
Slide 20 : Summary: Long term : RAS
Anti-hypertensive (BP) drugs: Classes : Anti-hypertensive (BP) drugs: Classes Diuretics :
Sympatholytic Drugs : (Discussed all these in previous lect)
►Alpha 2 selective agonists
► Adrenergic blockers :
▪Beta blockers
▪Alpha blockers
▪a & b blockers
Angiotensin Converting Enzyme (ACE) Inhibitors
Calcium Channel Blockers
Vasodilators
Slide 22 : Which drug prevent uptake into the storage vesicle.?
(disrupts norepinephrine vesicular storage;)
Not cocaine, but same type of action
Side Effects:
Depression
Slide 23 : Reserpine – Prevent uptake into the storage vesicle.
Reserpine disrupts norepinephrine vesicular storage;
reserpine has both central and peripheral action; can be used to treat mild to moderate hypertension
Side Effects:
Sedation
Diarrhea
Depression
Bradycardia
Nasal congestion
Slide 24 : Most extensively used hypotensive agent (drug) in management of hypertension in pregnant women?
Slide 25 : Methyl dopa
Therapeutic Notes:
Most extensively used hypotensive agent in management of hypertension in pregnant women
Slide 26 : Of the following, which is the drug of choice for HTN and BPH
Alpha 1 blockers:
Prazosin
Terazosin
Doxazosin
Alfuzosin
Tamsulosin
Slide 27 : Of the following, which is the drug of choice for HTN and BPH
Alpha 1 blockers:
Prazosin
Terazosin
Doxazosin
Alfuzosin
Tamsulosin
Slide 28 : Note: ACEIs (Ace Inhibitors)------inhibit ACE-----blocking the formation of Angiotensin II
Slide 29 : ACEIs (Ace Inhibitors)------inhibit ACE-----blocking the formation of Angiotensin II
Slide 30 :
Remember: : Remember: Ace is dating April; who has a dry cough, Angioedema, and a lot of potassium (Hyperkalemia)!
Do not get her Pregnant
ACEI drugs- Notice they all end in “PRIL” : ACEI drugs- Notice they all end in “PRIL” Imp: Both (ACEIs, ARBs) slow the progression of Nephropathy (nerve damage) in Diabetes by decreasing Glomerular efferent resistance.
**Do not give if Pregnant or if they have Bilateral renal artery stenosis. ** Enalapril
Lisinopril
Fosinopril
Ramipril
Quinapril
Moexipril
Benazepril
Captopril
Side Effect of ACE Inhibitors: : Side Effect of ACE Inhibitors: Hyperkalemia
Altered taste
Rash
Dry cough, fever ………. Most common
Angioneurotic edema (0.2% cases)
Teratogenic:
Fetal hypotension
Renal failure (in fetus)
Skull and Renal malformations
Angioedema- rapid swelling of the dermis, subcutaneous tissue, mucosa and submucosal tissues
Gynaecomastia -Excessive development of the breasts in males
Angiotensin II Antagonists (ARB)-Drugs that prevent Angiotensin II action : Angiotensin II Antagonists (ARB)-Drugs that prevent Angiotensin II action Primary Mechanism of Action: relax smooth muscle and thereby promote vasodilation, increase salt and water excretion, decrease plasma volume
Losartan
Valsartan
Candesartan
Olmesartan
Irbesartan
Telmisartan
Eprosartan Note that they end in “-ARTAN”
Side Effect: Hyperkalemia