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HTN is a major cause of death and disability. On your own!
Diuretics are effective at reducing mild to moderate HTN—Table 15.3 pg. 260 Used also to treat heart failure or kidney disease. Few adverse effects Frequently used with other antihypertensives to enhance effectiveness.
Reduce blood volume through urinary excretion of water and electrolytes Electrolyte imbalances can
occur Depends on type of diuretic.
Drug profile— hydrochlorothiazide (hydrodiuril) pg. 261
Calcium channel blockers have emerged as major drugs in the treatment of HTN—Table 15.4 pg. 262. Used also to treat angina pectoris and cardiac arrhythmias Vary in potency, frequency and types of side effects Prevent calcium ions from entering muscle cells Relax arterioles Lower peripheral resistance DP—nifedipine (Procardia) pg. 265
Angiotension converting enzyme (ACE) inhibitors block the renin-angiotensin pathway leads to a decrease in blood pressure—Table 15.5 pg. 264. Used also to treat heart failure and MI.
Block enzyme that changes angiotensin I to angiotensin II No constriction of arterioles—
decrease peripheral resistance No secretion of aldosterone— decrease blood volume. Some ACE inhibitors cause persistent cough after first dose DP-enalapril (Vasotec) pg. 268
Adrenergic blockers—organs innervated by the ANS are a frequent target for antihypertensive agents—Table 15.6 pg. 269. Block effects of sympathetic division of ANS—different mechanism—all lower BP. DP—doxazosin (Cardura)— alpha 1 adrenergic blockers. Pg. 270.
Direct acting vasodilators —some drugs act directly on arteriolar smooth muscle to lower BP— Table 15.7 pg. 271. Too many side effects to be drug of first choice. DP—hydrolazine (Apresoline) pg. 271