尊敬的 微信汇率:1円 ≈ 0.046166 元 支付宝汇率:1円 ≈ 0.046257元 [退出登录]
SlideShare a Scribd company logo
Syed Sulaiman
Pharmacology
Anesthesia
AMI Peshawar
 Introduction to hypertension
 Causes of hypertension
 Mechanism for controlling blood
pressure
◦ Baroreceptors
◦ Renin-angiotensin-aldosterone
system
 Anti-hypertensive drugs
 Also known as high blood pressure (HBP)
 Long-term medical condition in which the
blood pressure in the arteries is increases
 Systolic blood pressure of greater than 140 mm Hg
 Diastolic blood pressure of greater than 90 mm Hg
 Normal: 120/80
 Elevated blood pressure is an extremely
common disorder, affecting approximately 15
percent of the population of the United States
(60 million people)
 Family history
 Age
 Diabetics
 Obesity
 Disability states
 Environmental factors
◦ Stressful life
◦ Increase Na+
◦ smoking
 Hypertension is directly related to the
cardiac output
 Cardiac output and peripheral
resistance, in turn, are controlled
mainly by two overlapping control
mechanisms:
A. Baroreceptors
B. Renin-angiotensin-aldosterone system
 Baroreceptors are present in the aortic arch
 Baroreflexes act by changing the activity of
the sympathetic nervous system
 Therefore, they are responsible for the rapid,
moment-to-moment regulation of blood
pressure
 If blood pressure increases baroreceptors
activated and send fewer impulses to
cardiovascular centers in the spinal cord
 This prompts a reflex response of increased
sympathetic and decreased parasympathetic
output to the heart and vasculature,
resulting in vasoconstriction and increased
cardiac output
 The kidney provides for the long-term control of
blood pressure by altering the blood volume
 Baroreceptors in the kidney respond to reduced
arterial pressure by releasing the enzyme renin
 Low sodium intake and greater sodium loss also
increase renin release
 This renin converts angiotensinogen to angiotensin
I, which is converted, in turn to angiotensin II, in
the presence of angiotensin-converting enzyme
(ACE)
 Angiotensin II is a potent circulating
vasoconstrictor
 Constricting both arterioles and veins,
causing an
◦ Increase GFR
◦ Increase renal Na+ reabsorption
◦ Stimulate aldosterone secretion
◦ increase in blood pressure
 Anti-hypertensive dugs contain the following
groups
◦ Diuretics
◦ Beta blockers
◦ ACE inhibiters
◦ Angiotensin II receptors blockers
◦ Renin inhibiters
◦ Alpha receptors blockers
◦ Calcium Chanel blockers
◦ Centrally acting adrenergic drugs
◦ Vasodilators
A. Thiazide diuretics
 “Hydrochlorothiazide and chlorothalidone”
 lower blood pressure initially by increasing
sodium and water excretion
 This causes a decrease in extracellular
volume, resulting in a decrease in cardiac
output and renal blood flow
 Thus decrease in B.P.
 Thiazide diuretics induce hypokalemia and
hyperuricemia in 70 percent of patients and
hyperglycemia in 10 percent of patients
B. Loop diuretics
 “Furosemide, bumetanide, and
torsemide”
 These drugs inhibit the Na/K+ co-
transport in ascending loop of henle
 Thus decrease the reabsorption of
ions
C. Potassium-sparing diuretics
 “Amiloride, spironolactone,
triamterene”
 These drugs decrease k+
reabsorption
 “propranolol, metoprolol, atenolol etc”
 The β-blockers reduce blood pressure
primarily by decreasing cardiac output
 They may also decrease sympathetic outflow
from the central nervous system (CNS) and
inhibit the release of renin from the kidneys,
 Thus decreasing the formation of angiotensin
II and the secretion of aldosterone
 Hypotension
 Bradycardia
 Fatigue
 Insomnia
 Sexual dysfunction
 “Enalapril, lisinopril”
 The ACE inhibitors lower blood pressure by
reducing peripheral vascular resistance
without reflexively increasing cardiac output,
rate, or contractility
 These drugs block the ACE that cleaves
angiotensin I to form the potent
vasoconstrictor angiotensin II
 Dry cough
 Skin rash
 Fever
 altered taste
 hypotension (in hypovolemic states),
and
 hyperkalemia
 “Losartan, irbesartan”
 The ARBs are alternatives to the ACE
inhibitors
 These drugs block the AT1 receptors
 Their pharmacologic eff ects are similar to
those of ACE inhibitors in that they produce
arteriolar and venous dilation and block
aldosterone secretion, thus lowering blood
pressure and decreasing salt and water
retention
 “aliskiren”
 Aliskiren directly inhibits renin and, thus, acts
earlier in the renin-angiotensin-aldosterone
system than do ACE inhibitors or ARBs
 It lowers blood pressure about as effectively
as ARBs, ACE inhibitors, and thiazides
 Aliskiren can cause diarrhea, especially at
higher doses
 Aliskiren can also cause cough and
angioedema but probably less often than ACE
inhibitors
 They are effective in treating
hypertension in patients with angina
or diabetes
 The calcium-channel blockers are
divided into three chemical classes
1. Diphenylalkylamines
2. Benzodiazepines
3. Dihydropyridines
 Verapamil is the only member of this class
that is currently approved in the United States
 Verapamil is the least selective of any
calcium-channel blocker and has significant
effects on both cardiac and vascular smooth
muscle cells
 It is also used to treat angina,
supraventricular tachyarrhythmia's, and to
prevent migraine and cluster headaches
 Diltiazem is the only member of this
class that is currently approved in the
United States
 Like verapamil, diltiazem affects both
cardiac and vascular smooth muscle
cells, but it has a less pronounced
negative inotropic effect on the heart
compared to that of verapamil
 This group includes the first-generation
“Nifedipine” and
 five second-generation agents
◦ Amlodipine, felodipine, isradipine, nicardipine, and
nisoldipine
 All dihydropyridines have a much greater
affinity for vascular calcium channels than for
calcium channels in the heart
 Calcium enters muscle cells through special
voltage-sensitive calcium channels
 Calcium-channel antagonists block the
inward movement of calcium by binding to
L-type calcium channels in the heart and in
smooth muscle of the coronary and
peripheral arteriolar vasculature
 This causes vascular smooth muscle to
relax, dilating mainly arterioles
 Clonidine
◦ Inhibit sympathetic vasomotor center
◦ Reduce total peripheral resistance
◦ Decrease BP
 α-Methyldopa
◦ Diminished adrenergic outflow from the
CNS
◦ This leads to reduced total peripheral
resistance and decreased blood pressure
 “Hydralazine , minoxidil”
 These are not used primary drugs to treat
hypertension
 These vasodilators act by producing
relaxation of vascular smooth muscles artery
and arterioles
 Thus result in decrease peripheral resistance
and therefore BP
Anti hypertensive drugs

More Related Content

What's hot

Antianginal Drugs
Antianginal DrugsAntianginal Drugs
Antianginal Drugs
Subramani Parasuraman
 
Potassium sparing diuretics
Potassium sparing diureticsPotassium sparing diuretics
Potassium sparing diuretics
Domina Petric
 
Arrythmia
ArrythmiaArrythmia
Arrythmia
aishuanju
 
Drugs used in cardio vascular system- Mr. panneh
Drugs used in cardio vascular system- Mr. pannehDrugs used in cardio vascular system- Mr. panneh
Drugs used in cardio vascular system- Mr. panneh
abdou panneh
 
Pharmacological management of heart failure
Pharmacological management of heart failurePharmacological management of heart failure
Pharmacological management of heart failure
Naser Tadvi
 
Antiarrhythmic drugs
Antiarrhythmic drugs Antiarrhythmic drugs
Antiarrhythmic drugs
Ashfaq Ahmad
 
Ant ihypertensive
Ant ihypertensiveAnt ihypertensive
Ant ihypertensive
Monika Devi NR
 
Pathology of Hypertension
Pathology of HypertensionPathology of Hypertension
Pathology of Hypertension
Shashidhar Venkatesh Murthy
 
Diuretics-Mechanism of action,Diuretic Types and Adverse effects,Drug specifi...
Diuretics-Mechanism of action,Diuretic Types and Adverse effects,Drug specifi...Diuretics-Mechanism of action,Diuretic Types and Adverse effects,Drug specifi...
Diuretics-Mechanism of action,Diuretic Types and Adverse effects,Drug specifi...
varinder kumar
 
Angina pectoris
Angina pectorisAngina pectoris
Angina pectoris
sivasakthikannappan1
 
Antihypertensive drugs naser
Antihypertensive drugs naserAntihypertensive drugs naser
Antihypertensive drugs naser
Naser Tadvi
 
Myocardial ischemia
Myocardial ischemiaMyocardial ischemia
Myocardial ischemia
priyanka.p. Nayak
 
Congestive heart failure
Congestive heart failure Congestive heart failure
Congestive heart failure
Muhammadasif909
 
Antiplatelets and anticoagulants
Antiplatelets and anticoagulantsAntiplatelets and anticoagulants
Antiplatelets and anticoagulants
Edson Mutandwa
 
Antihypertensives
AntihypertensivesAntihypertensives
Antihypertensives
raj kumar
 
Antiarrythmic drugs
Antiarrythmic drugsAntiarrythmic drugs
Antianginal drugs and drugs used in ischaemia - drdhriti
Antianginal drugs and drugs used in ischaemia - drdhritiAntianginal drugs and drugs used in ischaemia - drdhriti
Antianginal drugs and drugs used in ischaemia - drdhriti
http://neigrihms.gov.in/
 
Malaria.pdf
Malaria.pdfMalaria.pdf
Malaria.pdf
GOWRI PRIYA
 
Pathophysiology of congestive heart failure
Pathophysiology of congestive heart failurePathophysiology of congestive heart failure
Pathophysiology of congestive heart failure
thunderrajesh
 
Antihypertensive agents
Antihypertensive agentsAntihypertensive agents
Antihypertensive agents
kencha swathi
 

What's hot (20)

Antianginal Drugs
Antianginal DrugsAntianginal Drugs
Antianginal Drugs
 
Potassium sparing diuretics
Potassium sparing diureticsPotassium sparing diuretics
Potassium sparing diuretics
 
Arrythmia
ArrythmiaArrythmia
Arrythmia
 
Drugs used in cardio vascular system- Mr. panneh
Drugs used in cardio vascular system- Mr. pannehDrugs used in cardio vascular system- Mr. panneh
Drugs used in cardio vascular system- Mr. panneh
 
Pharmacological management of heart failure
Pharmacological management of heart failurePharmacological management of heart failure
Pharmacological management of heart failure
 
Antiarrhythmic drugs
Antiarrhythmic drugs Antiarrhythmic drugs
Antiarrhythmic drugs
 
Ant ihypertensive
Ant ihypertensiveAnt ihypertensive
Ant ihypertensive
 
Pathology of Hypertension
Pathology of HypertensionPathology of Hypertension
Pathology of Hypertension
 
Diuretics-Mechanism of action,Diuretic Types and Adverse effects,Drug specifi...
Diuretics-Mechanism of action,Diuretic Types and Adverse effects,Drug specifi...Diuretics-Mechanism of action,Diuretic Types and Adverse effects,Drug specifi...
Diuretics-Mechanism of action,Diuretic Types and Adverse effects,Drug specifi...
 
Angina pectoris
Angina pectorisAngina pectoris
Angina pectoris
 
Antihypertensive drugs naser
Antihypertensive drugs naserAntihypertensive drugs naser
Antihypertensive drugs naser
 
Myocardial ischemia
Myocardial ischemiaMyocardial ischemia
Myocardial ischemia
 
Congestive heart failure
Congestive heart failure Congestive heart failure
Congestive heart failure
 
Antiplatelets and anticoagulants
Antiplatelets and anticoagulantsAntiplatelets and anticoagulants
Antiplatelets and anticoagulants
 
Antihypertensives
AntihypertensivesAntihypertensives
Antihypertensives
 
Antiarrythmic drugs
Antiarrythmic drugsAntiarrythmic drugs
Antiarrythmic drugs
 
Antianginal drugs and drugs used in ischaemia - drdhriti
Antianginal drugs and drugs used in ischaemia - drdhritiAntianginal drugs and drugs used in ischaemia - drdhriti
Antianginal drugs and drugs used in ischaemia - drdhriti
 
Malaria.pdf
Malaria.pdfMalaria.pdf
Malaria.pdf
 
Pathophysiology of congestive heart failure
Pathophysiology of congestive heart failurePathophysiology of congestive heart failure
Pathophysiology of congestive heart failure
 
Antihypertensive agents
Antihypertensive agentsAntihypertensive agents
Antihypertensive agents
 

Similar to Anti hypertensive drugs

Antihypertensives
AntihypertensivesAntihypertensives
Antihypertensives
Rosetta Davis
 
Hypertension Definition & management & types & treatment
Hypertension Definition & management & types & treatmentHypertension Definition & management & types & treatment
Hypertension Definition & management & types & treatment
Dr / Mohamed Ahmed
 
Cardiovascular drugs-Antihypertensive drugs
Cardiovascular drugs-Antihypertensive drugsCardiovascular drugs-Antihypertensive drugs
Cardiovascular drugs-Antihypertensive drugs
Pavithra Pavi
 
HYPERTENSION - SLIDE SHARE PRESENTATION.
HYPERTENSION - SLIDE SHARE PRESENTATION.HYPERTENSION - SLIDE SHARE PRESENTATION.
HYPERTENSION - SLIDE SHARE PRESENTATION.
deepaannamalai16
 
Cardiodrugs
CardiodrugsCardiodrugs
Cardiodrugs
Tosca Torres
 
Anti hypertensive drugs Biomedical science slideshare
Anti hypertensive drugs Biomedical science slideshareAnti hypertensive drugs Biomedical science slideshare
Anti hypertensive drugs Biomedical science slideshare
JersitaSherley
 
Antihypertensives acting on RAAS
Antihypertensives acting on RAASAntihypertensives acting on RAAS
Antihypertensives acting on RAAS
Ankita Bist
 
Antihypertensive drugs 2015-16
Antihypertensive drugs 2015-16Antihypertensive drugs 2015-16
Antihypertensive drugs 2015-16
College of Pharmacy University of Sulaimani
 
hypertension-161006095542.pptx
hypertension-161006095542.pptxhypertension-161006095542.pptx
hypertension-161006095542.pptx
DavudAhmedzade
 
Week 5 Pharma
Week 5 PharmaWeek 5 Pharma
Week 5 Pharma
xtrm nurse
 
Antihypertensives | Classes of Drugs | Baro Receptor
Antihypertensives | Classes of Drugs | Baro ReceptorAntihypertensives | Classes of Drugs | Baro Receptor
Antihypertensives | Classes of Drugs | Baro Receptor
Chetan Prakash
 
Hypertension
HypertensionHypertension
Hypertension
Ratheeshkrishnakripa
 
hypertension-161006095542 (1).pdf
hypertension-161006095542 (1).pdfhypertension-161006095542 (1).pdf
hypertension-161006095542 (1).pdf
jiregnaetichadako
 
Hypertension
HypertensionHypertension
Hypertension
Ratheeshkrishnakripa
 
lecture-3 hypertantion.pdf
lecture-3 hypertantion.pdflecture-3 hypertantion.pdf
lecture-3 hypertantion.pdf
Obsa2
 
Hypertension
HypertensionHypertension
Hypertension
NedaFatima4
 
1. Anti hypertensive drugs.pptx what's hypertension
1. Anti hypertensive drugs.pptx what's hypertension1. Anti hypertensive drugs.pptx what's hypertension
1. Anti hypertensive drugs.pptx what's hypertension
Khyber medical university
 
Hypertension llb explains by harrionsion book
Hypertension llb explains by harrionsion bookHypertension llb explains by harrionsion book
Hypertension llb explains by harrionsion book
nxrg25985g
 
Hypertension-Blood Pressure (Pharmacotherapeutics)
Hypertension-Blood Pressure (Pharmacotherapeutics)Hypertension-Blood Pressure (Pharmacotherapeutics)
Hypertension-Blood Pressure (Pharmacotherapeutics)
SHIVANEE VYAS
 
Ahtd4
Ahtd4Ahtd4

Similar to Anti hypertensive drugs (20)

Antihypertensives
AntihypertensivesAntihypertensives
Antihypertensives
 
Hypertension Definition & management & types & treatment
Hypertension Definition & management & types & treatmentHypertension Definition & management & types & treatment
Hypertension Definition & management & types & treatment
 
Cardiovascular drugs-Antihypertensive drugs
Cardiovascular drugs-Antihypertensive drugsCardiovascular drugs-Antihypertensive drugs
Cardiovascular drugs-Antihypertensive drugs
 
HYPERTENSION - SLIDE SHARE PRESENTATION.
HYPERTENSION - SLIDE SHARE PRESENTATION.HYPERTENSION - SLIDE SHARE PRESENTATION.
HYPERTENSION - SLIDE SHARE PRESENTATION.
 
Cardiodrugs
CardiodrugsCardiodrugs
Cardiodrugs
 
Anti hypertensive drugs Biomedical science slideshare
Anti hypertensive drugs Biomedical science slideshareAnti hypertensive drugs Biomedical science slideshare
Anti hypertensive drugs Biomedical science slideshare
 
Antihypertensives acting on RAAS
Antihypertensives acting on RAASAntihypertensives acting on RAAS
Antihypertensives acting on RAAS
 
Antihypertensive drugs 2015-16
Antihypertensive drugs 2015-16Antihypertensive drugs 2015-16
Antihypertensive drugs 2015-16
 
hypertension-161006095542.pptx
hypertension-161006095542.pptxhypertension-161006095542.pptx
hypertension-161006095542.pptx
 
Week 5 Pharma
Week 5 PharmaWeek 5 Pharma
Week 5 Pharma
 
Antihypertensives | Classes of Drugs | Baro Receptor
Antihypertensives | Classes of Drugs | Baro ReceptorAntihypertensives | Classes of Drugs | Baro Receptor
Antihypertensives | Classes of Drugs | Baro Receptor
 
Hypertension
HypertensionHypertension
Hypertension
 
hypertension-161006095542 (1).pdf
hypertension-161006095542 (1).pdfhypertension-161006095542 (1).pdf
hypertension-161006095542 (1).pdf
 
Hypertension
HypertensionHypertension
Hypertension
 
lecture-3 hypertantion.pdf
lecture-3 hypertantion.pdflecture-3 hypertantion.pdf
lecture-3 hypertantion.pdf
 
Hypertension
HypertensionHypertension
Hypertension
 
1. Anti hypertensive drugs.pptx what's hypertension
1. Anti hypertensive drugs.pptx what's hypertension1. Anti hypertensive drugs.pptx what's hypertension
1. Anti hypertensive drugs.pptx what's hypertension
 
Hypertension llb explains by harrionsion book
Hypertension llb explains by harrionsion bookHypertension llb explains by harrionsion book
Hypertension llb explains by harrionsion book
 
Hypertension-Blood Pressure (Pharmacotherapeutics)
Hypertension-Blood Pressure (Pharmacotherapeutics)Hypertension-Blood Pressure (Pharmacotherapeutics)
Hypertension-Blood Pressure (Pharmacotherapeutics)
 
Ahtd4
Ahtd4Ahtd4
Ahtd4
 

Recently uploaded

Ludhiana Call Girls 💯Call Us 🔝 7374876321 🔝 💃 Independent Female Escort Service
Ludhiana Call Girls 💯Call Us 🔝 7374876321 🔝 💃 Independent Female Escort ServiceLudhiana Call Girls 💯Call Us 🔝 7374876321 🔝 💃 Independent Female Escort Service
Ludhiana Call Girls 💯Call Us 🔝 7374876321 🔝 💃 Independent Female Escort Service
gragdeepa
 
Amritsar Call Girls 💯Call Us 🔝 7374876321 🔝 💃 Independent Female Escort Service
Amritsar Call Girls 💯Call Us 🔝 7374876321 🔝 💃 Independent Female Escort ServiceAmritsar Call Girls 💯Call Us 🔝 7374876321 🔝 💃 Independent Female Escort Service
Amritsar Call Girls 💯Call Us 🔝 7374876321 🔝 💃 Independent Female Escort Service
summanareddy
 
HEALTH ASSESSMENT IN NURSING USING THE NURSING PROCESSpptx
HEALTH ASSESSMENT IN NURSING USING THE NURSING PROCESSpptxHEALTH ASSESSMENT IN NURSING USING THE NURSING PROCESSpptx
HEALTH ASSESSMENT IN NURSING USING THE NURSING PROCESSpptx
Rommel Luis III Israel
 
Linga Mudra(Mark of Siva) generates excessive heat within the body
Linga Mudra(Mark of Siva) generates excessive heat within the bodyLinga Mudra(Mark of Siva) generates excessive heat within the body
Linga Mudra(Mark of Siva) generates excessive heat within the body
Karuna Yoga Vidya Peetham
 
Apana Mudra(Cleansing Energy Gesture)pp.pptx
Apana Mudra(Cleansing Energy Gesture)pp.pptxApana Mudra(Cleansing Energy Gesture)pp.pptx
Apana Mudra(Cleansing Energy Gesture)pp.pptx
Karuna Yoga Vidya Peetham
 
Verified Call Girls Hyderabad 💯Call Us 🔝 7426014248 🔝Independent Hyderabad Es...
Verified Call Girls Hyderabad 💯Call Us 🔝 7426014248 🔝Independent Hyderabad Es...Verified Call Girls Hyderabad 💯Call Us 🔝 7426014248 🔝Independent Hyderabad Es...
Verified Call Girls Hyderabad 💯Call Us 🔝 7426014248 🔝Independent Hyderabad Es...
rehmti665
 
Call Girls RA Puram 8824825030 Top Class Chennai Escorts Available
Call Girls RA Puram 8824825030 Top Class Chennai Escorts AvailableCall Girls RA Puram 8824825030 Top Class Chennai Escorts Available
Call Girls RA Puram 8824825030 Top Class Chennai Escorts Available
simrankaur
 
Call Girls Kolkata 8824825030 Top Class Kolkata Escorts Available
Call Girls Kolkata 8824825030 Top Class Kolkata Escorts AvailableCall Girls Kolkata 8824825030 Top Class Kolkata Escorts Available
Call Girls Kolkata 8824825030 Top Class Kolkata Escorts Available
kmiss 1062#v08
 
ASSESSMENT OF THE EYE (2)-Health Assessment.pptx
ASSESSMENT OF THE EYE (2)-Health Assessment.pptxASSESSMENT OF THE EYE (2)-Health Assessment.pptx
ASSESSMENT OF THE EYE (2)-Health Assessment.pptx
Rommel Luis III Israel
 
Footfalls & Heartbeats X Wearable X Breathing Survey (2).pdf
Footfalls & Heartbeats X Wearable X Breathing Survey (2).pdfFootfalls & Heartbeats X Wearable X Breathing Survey (2).pdf
Footfalls & Heartbeats X Wearable X Breathing Survey (2).pdf
simon613400
 
Effect of Repeated low-level red light therapy in.pptx
Effect of Repeated low-level red light therapy in.pptxEffect of Repeated low-level red light therapy in.pptx
Effect of Repeated low-level red light therapy in.pptx
Manojitbasak4
 
Types of Cancer Treatments | Forms of cancer treatment
Types of Cancer Treatments | Forms of cancer treatmentTypes of Cancer Treatments | Forms of cancer treatment
Types of Cancer Treatments | Forms of cancer treatment
RioGrandeCancerSpeci
 
Psychological Safety as a Foundation for Improvement 12-06-24.pdf
Psychological Safety as a Foundation for Improvement 12-06-24.pdfPsychological Safety as a Foundation for Improvement 12-06-24.pdf
Psychological Safety as a Foundation for Improvement 12-06-24.pdf
Healthcare Improvement Support
 
ASSESSMENT OF THE EYE (1)-Health Assessment.ppt
ASSESSMENT OF THE EYE (1)-Health Assessment.pptASSESSMENT OF THE EYE (1)-Health Assessment.ppt
ASSESSMENT OF THE EYE (1)-Health Assessment.ppt
Rommel Luis III Israel
 
Unlimited Short Call Girls Thane ✅ 9833325238 FULL CASH PAYMENT
Unlimited Short Call Girls Thane ✅ 9833325238 FULL CASH PAYMENTUnlimited Short Call Girls Thane ✅ 9833325238 FULL CASH PAYMENT
Unlimited Short Call Girls Thane ✅ 9833325238 FULL CASH PAYMENT
rajesh344555
 
CSE presentation 050804-nikhil tandon.ppt
CSE presentation 050804-nikhil tandon.pptCSE presentation 050804-nikhil tandon.ppt
CSE presentation 050804-nikhil tandon.ppt
vattakandyrahoof8
 
Seizure Nursing care plan with journal reference
Seizure Nursing care plan with journal referenceSeizure Nursing care plan with journal reference
Seizure Nursing care plan with journal reference
Google
 
Call Girls Udaipur 8824825030 Escort In Udaipur service 24X7
Call Girls Udaipur 8824825030 Escort In Udaipur service 24X7Call Girls Udaipur 8824825030 Escort In Udaipur service 24X7
Call Girls Udaipur 8824825030 Escort In Udaipur service 24X7
misschadda74
 
Vital statistics.pptx Vital statistics, the records of birth and death, are a...
Vital statistics.pptx Vital statistics, the records of birth and death, are a...Vital statistics.pptx Vital statistics, the records of birth and death, are a...
Vital statistics.pptx Vital statistics, the records of birth and death, are a...
Sapna Thakur
 
PROGRAMMING OF HANAU WIDE VUE & GOTHIC ARCH TRACING.pptx
PROGRAMMING OF HANAU WIDE VUE & GOTHIC ARCH TRACING.pptxPROGRAMMING OF HANAU WIDE VUE & GOTHIC ARCH TRACING.pptx
PROGRAMMING OF HANAU WIDE VUE & GOTHIC ARCH TRACING.pptx
SatvikaPrasad
 

Recently uploaded (20)

Ludhiana Call Girls 💯Call Us 🔝 7374876321 🔝 💃 Independent Female Escort Service
Ludhiana Call Girls 💯Call Us 🔝 7374876321 🔝 💃 Independent Female Escort ServiceLudhiana Call Girls 💯Call Us 🔝 7374876321 🔝 💃 Independent Female Escort Service
Ludhiana Call Girls 💯Call Us 🔝 7374876321 🔝 💃 Independent Female Escort Service
 
Amritsar Call Girls 💯Call Us 🔝 7374876321 🔝 💃 Independent Female Escort Service
Amritsar Call Girls 💯Call Us 🔝 7374876321 🔝 💃 Independent Female Escort ServiceAmritsar Call Girls 💯Call Us 🔝 7374876321 🔝 💃 Independent Female Escort Service
Amritsar Call Girls 💯Call Us 🔝 7374876321 🔝 💃 Independent Female Escort Service
 
HEALTH ASSESSMENT IN NURSING USING THE NURSING PROCESSpptx
HEALTH ASSESSMENT IN NURSING USING THE NURSING PROCESSpptxHEALTH ASSESSMENT IN NURSING USING THE NURSING PROCESSpptx
HEALTH ASSESSMENT IN NURSING USING THE NURSING PROCESSpptx
 
Linga Mudra(Mark of Siva) generates excessive heat within the body
Linga Mudra(Mark of Siva) generates excessive heat within the bodyLinga Mudra(Mark of Siva) generates excessive heat within the body
Linga Mudra(Mark of Siva) generates excessive heat within the body
 
Apana Mudra(Cleansing Energy Gesture)pp.pptx
Apana Mudra(Cleansing Energy Gesture)pp.pptxApana Mudra(Cleansing Energy Gesture)pp.pptx
Apana Mudra(Cleansing Energy Gesture)pp.pptx
 
Verified Call Girls Hyderabad 💯Call Us 🔝 7426014248 🔝Independent Hyderabad Es...
Verified Call Girls Hyderabad 💯Call Us 🔝 7426014248 🔝Independent Hyderabad Es...Verified Call Girls Hyderabad 💯Call Us 🔝 7426014248 🔝Independent Hyderabad Es...
Verified Call Girls Hyderabad 💯Call Us 🔝 7426014248 🔝Independent Hyderabad Es...
 
Call Girls RA Puram 8824825030 Top Class Chennai Escorts Available
Call Girls RA Puram 8824825030 Top Class Chennai Escorts AvailableCall Girls RA Puram 8824825030 Top Class Chennai Escorts Available
Call Girls RA Puram 8824825030 Top Class Chennai Escorts Available
 
Call Girls Kolkata 8824825030 Top Class Kolkata Escorts Available
Call Girls Kolkata 8824825030 Top Class Kolkata Escorts AvailableCall Girls Kolkata 8824825030 Top Class Kolkata Escorts Available
Call Girls Kolkata 8824825030 Top Class Kolkata Escorts Available
 
ASSESSMENT OF THE EYE (2)-Health Assessment.pptx
ASSESSMENT OF THE EYE (2)-Health Assessment.pptxASSESSMENT OF THE EYE (2)-Health Assessment.pptx
ASSESSMENT OF THE EYE (2)-Health Assessment.pptx
 
Footfalls & Heartbeats X Wearable X Breathing Survey (2).pdf
Footfalls & Heartbeats X Wearable X Breathing Survey (2).pdfFootfalls & Heartbeats X Wearable X Breathing Survey (2).pdf
Footfalls & Heartbeats X Wearable X Breathing Survey (2).pdf
 
Effect of Repeated low-level red light therapy in.pptx
Effect of Repeated low-level red light therapy in.pptxEffect of Repeated low-level red light therapy in.pptx
Effect of Repeated low-level red light therapy in.pptx
 
Types of Cancer Treatments | Forms of cancer treatment
Types of Cancer Treatments | Forms of cancer treatmentTypes of Cancer Treatments | Forms of cancer treatment
Types of Cancer Treatments | Forms of cancer treatment
 
Psychological Safety as a Foundation for Improvement 12-06-24.pdf
Psychological Safety as a Foundation for Improvement 12-06-24.pdfPsychological Safety as a Foundation for Improvement 12-06-24.pdf
Psychological Safety as a Foundation for Improvement 12-06-24.pdf
 
ASSESSMENT OF THE EYE (1)-Health Assessment.ppt
ASSESSMENT OF THE EYE (1)-Health Assessment.pptASSESSMENT OF THE EYE (1)-Health Assessment.ppt
ASSESSMENT OF THE EYE (1)-Health Assessment.ppt
 
Unlimited Short Call Girls Thane ✅ 9833325238 FULL CASH PAYMENT
Unlimited Short Call Girls Thane ✅ 9833325238 FULL CASH PAYMENTUnlimited Short Call Girls Thane ✅ 9833325238 FULL CASH PAYMENT
Unlimited Short Call Girls Thane ✅ 9833325238 FULL CASH PAYMENT
 
CSE presentation 050804-nikhil tandon.ppt
CSE presentation 050804-nikhil tandon.pptCSE presentation 050804-nikhil tandon.ppt
CSE presentation 050804-nikhil tandon.ppt
 
Seizure Nursing care plan with journal reference
Seizure Nursing care plan with journal referenceSeizure Nursing care plan with journal reference
Seizure Nursing care plan with journal reference
 
Call Girls Udaipur 8824825030 Escort In Udaipur service 24X7
Call Girls Udaipur 8824825030 Escort In Udaipur service 24X7Call Girls Udaipur 8824825030 Escort In Udaipur service 24X7
Call Girls Udaipur 8824825030 Escort In Udaipur service 24X7
 
Vital statistics.pptx Vital statistics, the records of birth and death, are a...
Vital statistics.pptx Vital statistics, the records of birth and death, are a...Vital statistics.pptx Vital statistics, the records of birth and death, are a...
Vital statistics.pptx Vital statistics, the records of birth and death, are a...
 
PROGRAMMING OF HANAU WIDE VUE & GOTHIC ARCH TRACING.pptx
PROGRAMMING OF HANAU WIDE VUE & GOTHIC ARCH TRACING.pptxPROGRAMMING OF HANAU WIDE VUE & GOTHIC ARCH TRACING.pptx
PROGRAMMING OF HANAU WIDE VUE & GOTHIC ARCH TRACING.pptx
 

Anti hypertensive drugs

  • 2.  Introduction to hypertension  Causes of hypertension  Mechanism for controlling blood pressure ◦ Baroreceptors ◦ Renin-angiotensin-aldosterone system  Anti-hypertensive drugs
  • 3.  Also known as high blood pressure (HBP)  Long-term medical condition in which the blood pressure in the arteries is increases  Systolic blood pressure of greater than 140 mm Hg  Diastolic blood pressure of greater than 90 mm Hg  Normal: 120/80  Elevated blood pressure is an extremely common disorder, affecting approximately 15 percent of the population of the United States (60 million people)
  • 4.  Family history  Age  Diabetics  Obesity  Disability states  Environmental factors ◦ Stressful life ◦ Increase Na+ ◦ smoking
  • 5.  Hypertension is directly related to the cardiac output  Cardiac output and peripheral resistance, in turn, are controlled mainly by two overlapping control mechanisms: A. Baroreceptors B. Renin-angiotensin-aldosterone system
  • 6.  Baroreceptors are present in the aortic arch  Baroreflexes act by changing the activity of the sympathetic nervous system  Therefore, they are responsible for the rapid, moment-to-moment regulation of blood pressure  If blood pressure increases baroreceptors activated and send fewer impulses to cardiovascular centers in the spinal cord
  • 7.  This prompts a reflex response of increased sympathetic and decreased parasympathetic output to the heart and vasculature, resulting in vasoconstriction and increased cardiac output
  • 8.  The kidney provides for the long-term control of blood pressure by altering the blood volume  Baroreceptors in the kidney respond to reduced arterial pressure by releasing the enzyme renin  Low sodium intake and greater sodium loss also increase renin release  This renin converts angiotensinogen to angiotensin I, which is converted, in turn to angiotensin II, in the presence of angiotensin-converting enzyme (ACE)
  • 9.  Angiotensin II is a potent circulating vasoconstrictor  Constricting both arterioles and veins, causing an ◦ Increase GFR ◦ Increase renal Na+ reabsorption ◦ Stimulate aldosterone secretion ◦ increase in blood pressure
  • 10.  Anti-hypertensive dugs contain the following groups ◦ Diuretics ◦ Beta blockers ◦ ACE inhibiters ◦ Angiotensin II receptors blockers ◦ Renin inhibiters ◦ Alpha receptors blockers ◦ Calcium Chanel blockers ◦ Centrally acting adrenergic drugs ◦ Vasodilators
  • 11. A. Thiazide diuretics  “Hydrochlorothiazide and chlorothalidone”  lower blood pressure initially by increasing sodium and water excretion  This causes a decrease in extracellular volume, resulting in a decrease in cardiac output and renal blood flow  Thus decrease in B.P.  Thiazide diuretics induce hypokalemia and hyperuricemia in 70 percent of patients and hyperglycemia in 10 percent of patients
  • 12. B. Loop diuretics  “Furosemide, bumetanide, and torsemide”  These drugs inhibit the Na/K+ co- transport in ascending loop of henle  Thus decrease the reabsorption of ions
  • 13. C. Potassium-sparing diuretics  “Amiloride, spironolactone, triamterene”  These drugs decrease k+ reabsorption
  • 14.  “propranolol, metoprolol, atenolol etc”  The β-blockers reduce blood pressure primarily by decreasing cardiac output  They may also decrease sympathetic outflow from the central nervous system (CNS) and inhibit the release of renin from the kidneys,  Thus decreasing the formation of angiotensin II and the secretion of aldosterone
  • 15.  Hypotension  Bradycardia  Fatigue  Insomnia  Sexual dysfunction
  • 16.  “Enalapril, lisinopril”  The ACE inhibitors lower blood pressure by reducing peripheral vascular resistance without reflexively increasing cardiac output, rate, or contractility  These drugs block the ACE that cleaves angiotensin I to form the potent vasoconstrictor angiotensin II
  • 17.  Dry cough  Skin rash  Fever  altered taste  hypotension (in hypovolemic states), and  hyperkalemia
  • 18.  “Losartan, irbesartan”  The ARBs are alternatives to the ACE inhibitors  These drugs block the AT1 receptors  Their pharmacologic eff ects are similar to those of ACE inhibitors in that they produce arteriolar and venous dilation and block aldosterone secretion, thus lowering blood pressure and decreasing salt and water retention
  • 19.  “aliskiren”  Aliskiren directly inhibits renin and, thus, acts earlier in the renin-angiotensin-aldosterone system than do ACE inhibitors or ARBs  It lowers blood pressure about as effectively as ARBs, ACE inhibitors, and thiazides  Aliskiren can cause diarrhea, especially at higher doses  Aliskiren can also cause cough and angioedema but probably less often than ACE inhibitors
  • 20.  They are effective in treating hypertension in patients with angina or diabetes  The calcium-channel blockers are divided into three chemical classes 1. Diphenylalkylamines 2. Benzodiazepines 3. Dihydropyridines
  • 21.  Verapamil is the only member of this class that is currently approved in the United States  Verapamil is the least selective of any calcium-channel blocker and has significant effects on both cardiac and vascular smooth muscle cells  It is also used to treat angina, supraventricular tachyarrhythmia's, and to prevent migraine and cluster headaches
  • 22.  Diltiazem is the only member of this class that is currently approved in the United States  Like verapamil, diltiazem affects both cardiac and vascular smooth muscle cells, but it has a less pronounced negative inotropic effect on the heart compared to that of verapamil
  • 23.  This group includes the first-generation “Nifedipine” and  five second-generation agents ◦ Amlodipine, felodipine, isradipine, nicardipine, and nisoldipine  All dihydropyridines have a much greater affinity for vascular calcium channels than for calcium channels in the heart
  • 24.  Calcium enters muscle cells through special voltage-sensitive calcium channels  Calcium-channel antagonists block the inward movement of calcium by binding to L-type calcium channels in the heart and in smooth muscle of the coronary and peripheral arteriolar vasculature  This causes vascular smooth muscle to relax, dilating mainly arterioles
  • 25.  Clonidine ◦ Inhibit sympathetic vasomotor center ◦ Reduce total peripheral resistance ◦ Decrease BP  α-Methyldopa ◦ Diminished adrenergic outflow from the CNS ◦ This leads to reduced total peripheral resistance and decreased blood pressure
  • 26.  “Hydralazine , minoxidil”  These are not used primary drugs to treat hypertension  These vasodilators act by producing relaxation of vascular smooth muscles artery and arterioles  Thus result in decrease peripheral resistance and therefore BP
  翻译: