Hypertension is defined as either a sustained systolic blood pressure of greater than 140 mm Hg or a sustained diastolic blood pressure of greater than 90 mm Hg.
Blood pressure =peripheral vascular resistance and cardiac out put.Cardiac out put=stroke volume x Heart rate.
1 Diuretics are drugs that increase the volume of urine elimination.
Diuretics drugs include
Loop Diuretics (furosemide, torsemide and bumetanide).
Diuretics drugs include
Loop Diuretics (furosemide, torsemide and bumetanide).
2 ACE-inhibitors =they lower blood pressure by reducing peripheral vascular resistance. These drugs block the enzyme ACE which cleaves a grotensin I
to form potent vasoconstriction angiotensin ll.By reducing circulating angiotensin II levels ,ACE inhibitors also decrease the secretion of aldosterone , resulting in decreased sodium and water retention.
3 Drugs of ACE inhibitors are captopril and enalapril
Side effects of ACE inhibitors:
Dry cough , rash, Hyperkalemia and Hypotension .
Pharmacokinetics of ACE inhibitors
All of the ACE inhibitors are orally bioavailable.
Side effects of ACE inhibitors:
Dry cough , rash, Hyperkalemia and Hypotension .
Pharmacokinetics of ACE inhibitors
All of the ACE inhibitors are orally bioavailable.
4 Calcium channel blockers
These drugs include Nifedipine and Amlodipine.
Calcium channel antagonist block the inward movement of Calcium by binding to L-type Calcium in the heart and in smooth muscle of the coronary and peripheral arteriolar vasculature. This causes vascular smooth muscle to relax.
Most of these agents have short half-lives(3 to 8 hours) following an oral dose.
5 Triamterene and amiloride
Triamterene and amiloride block Na+ transport channels, resulting in decrease in Na+ and/k+ exchange. Both Triamterene and amyloid are commonly used in combination with other diuretics, usually for their potassium sparing properties.
Triamterene and amiloride block Na+ transport channels, resulting in decrease in Na+ and/k+ exchange. Both Triamterene and amyloid are commonly used in combination with other diuretics, usually for their potassium sparing properties.
The side effects of Triamterene include increased uric acid,renal stones and k+ retention.
Carbonic a hydrate inhibitors .
Examples Acetazolamide
Acetazolamide and other carbonic anhydrase inhibitors are more often used for their other pharmacologic actions than for their diuretics effect , because they are much less afficacious than the thiazide or loop duiretics.
Carbonic a hydrate inhibitors .
Examples Acetazolamide
Acetazolamide and other carbonic anhydrase inhibitors are more often used for their other pharmacologic actions than for their diuretics effect , because they are much less afficacious than the thiazide or loop duiretics.
Mechanism of action .
Acetazolamide inhibits inhibits carbonic a hydrate located intracellularly(cytoplasm) and on the apical membrane of the proximal tubular epithelium. Carbonic a hydrate catalyzes the reaction of CO2 and H2O, leading to H2CO3.
Acetazolamide inhibits inhibits carbonic a hydrate located intracellularly(cytoplasm) and on the apical membrane of the proximal tubular epithelium. Carbonic a hydrate catalyzes the reaction of CO2 and H2O, leading to H2CO3.
Pharmacokinetics.
Acetazolamide can be administrated orally or intravenously. It is eliminated renally.
Adverse effects
Metabolic acidosis (mild), potassium depletion and drowsiness .
The drug should be avoided in patients with hepatic cirrhosis, because it could it lead to a decreased excretion of NH4+.
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