Hypertension Treatment Flashcards
Which are first line drugs in hypertension
Thiazides
Thiazide dose conc
Thiazides should be used at low doses only because by increasing the dose, antihypertensive effect does not increase but adverse effects tend to increase.
Indapamide req in what levels for hypertension
Lower than diuretic doses
Loop diuretics in hypertension
not indicated for mild to moderate hypertension because of the brisk diuresis leading to severe reduction in blood volume and electrolyte imbalance. However, these drugs are indicated in severe hypertension with CHF and renal dysfunction
Indacrinone - used in
Hypertension with gout
Potassium sparing diuretics used
Only in combo with thiazide to prevent complications due to hypokalemia
SYMPATHOPLEGICS are used in
This group of drugs is aimed at decreasing the activity of sympathetic system. Hypertension
Mechanism of sympathoplegics
decrease central sympathetic outflow,
block the autonomic ganglia,
deplete the neurotransmitter store
block the adrenergic receptors
Types of Drugs Inhibiting Central Sympathetic Outflow
, α2 agonists and β1 antagonists can decrease the sympathetic activity and are useful for the treatment of hypertension.
Examples of drugs acting on cns
Clonidine and α-methyl dopa act as α2 agonists in the brain.
Abrupt discontinuation of clonidine therapy
rebound hypertension (treated by phentolamine);
Side effect of methyl dopa
Methyl dopa can cause hemolytic anemia
Are clonidine and methyl dopa safe in preg
Both of these drugs are safe in pregnancy
Preg which drug is preffered
Alpha meth dopa
Changes when alpha meth dopa is put in iv
Clonidine, if administered by i.v. route initially leads to rapid rise in blood pressure followed by prolonged fall. The initial rise is due to the activation of vascularpost-synaptic α2 receptors by high concentration
of clonidine.
How does moxonidine and rilmenidine work
moxonidine and rilmenidine are congeners of clonidine with longer half lives. These drugs are selective for imidazoline receptors
that modulate the central α2 receptor activity.
What happens to sodium and water when central anti sympa is used
All of these drugs can result in sodium and water retention on prolonged use due to compensatory mechanisms.
How do we resensitize the central sympa drugs
Diuretics can be added to these agents to restore the sensitivity.
Ganglion blockers function
Inhibit nn type of receptor
How do side effect take place due to ganglion blockers
decreased transmission through parasympathetic ganglia is responsible for the adverse effects like urinary retention and dry mouth.
Examples of ganglion blockers
Hexamethonium, trimethaphan
Rilmenidine is an
Central sympa blocker
Moxonidine is an example of
Central sympa blocker
Antidotes for nicotine poisoning
Trimethaphan and hexamethonium
