22. Drugs used for the treatment of hypertension I: Classification of antihypertensive agents and their mechanisms of action

Question 1

What are the different drug groups for antihypertensive drugs?

Answer 1

• Diuretics
• Drugs acting on the sympathetic system
• Drugs acting on RAAS
• Vasodilators

Question 2

Which are the diuretics involved in the treatment of hypertension?

Answer 2

• Thiazides and related compounds:
  
  • ​Thiazide
  • Indampamide
  • Clorthalidone
  • Metolazone
  • Clopamide
• Loop diuretics:
  
  • ​Furosemide
  • Torsemide
  • Bumetanide
  • Ethacrynic acid
• Potassium-sparing diuretics:
  
  • Aldosterone receptor antagonists
    
    • ​​Eplerenone
    • Spironolactone
  • ENaC inhibitors
    
    • ​​Amiloride
    • Triamterene

Question 3

Which are the drugs acting on the sympathetic system?

Answer 3

• Centrally-acting sympatholytics:
  
  • ​Alpha2 receptor agonists
    
    • Clonidine, methyldopa, guaficine, guanabenz, dexmedetomidine and tizanidine
  • I₁ receptor agonists
    
    • Moxonidine, rilmenidine**​
• Peripherally-acting sympatholytics:
  
  • ​Ganglion blockers
    
    • Mecamylamine, trimetaphan, hexamethonium, tetraethylammonium
  • Indirect adrenergic neuron blocking agents
    
    • Metyrosine
    • Reserpine
    • Guanethidine
  • Non-selective alpha receptor blockers
    
    • Phenoxybenzamine
    • Phentolamine
    • Tolazoline
    • Ergot alkaloids
  • Selective alpha1 receptor blockers
    
    • Prazosine, doxazosin, terazosin, alfusosin, tamsulosin, urapidil
  • Beta blockers
    
    • Acebutolol, atenolol, betaxolol, bisprolol, celiprolol, …