MindMap Gallery pharmacological antihypertensive drugs
Chapter 25 of Pharmacology, including classification, commonly used drugs, Other drugs, new concepts in drug treatment of hypertension, etc. Hope it helps everyone.
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antihypertensive drugs
Classification
diuretics
Adrenoceptor blocking drug—propranolol
calcium channel blockers
Renin-angiotensin system inhibitors
ACE inhibitors (angiotensin-converting enzyme)
AT1 blockers (angiotensin type 1 receptor)
renin inhibitors
vasodilators
Commonly used drugs
Diuretics—Hydrochlorothiazide
antihypertensive mechanism
Early stage: Natriuresis and diuresis, reducing effective blood volume
Long-term: Reduce vascular resistance, excrete sodium ➡️Reduce calcium ➡️Vascular smooth muscle relaxation
Clinical application
mild early hypertension
Replacement - indapamide
calcium channel blockers
Mechanism: Inhibit calcium ion transport across membranes, relax vascular smooth muscle, and lower blood pressure
drug
Nifedipine (cardiac pain medication)
More sensitive to arteriolar smooth muscle
Disadvantages: Reflexive heart rate increase
Clinical: Can be used for patients with angina pectoris, kidney disease, diabetes, asthma, hyperlipidemia and malignant hypertension (sustained-release tablets are recommended)
Niqun Diping
The liver has been significantly eliminated
Lacidipine
amlodipine
Smoothly lowers blood pressure and lasts for a long time, used for hypertension and angina pectoris
Adverse reactions: peripheral edema
beta blockers
Propranolol (propranolol)
Does not produce orthostatic hypotension (prazosin)
Mild antihypertensive effect (highly lipophilic compound)
antihypertensive mechanism
Decrease cardiac output
Inhibit renin release
Inhibits sympathetic nervous system activity
Increase prostacyclin synthesis
clinical
essential hypertension
High blood pressure accompanied by angina, migraine, anxiety, etc.
Contraindications
Bronchial Asthma
Severe left ventricular dysfunction
sinus bradycardia
severe atrioventricular block
atenolol
labelore
carvedilol
(ACE inhibitors) angiotensin-converting enzyme inhibitors
Captopril
Short-acting before meals
antihypertensive mechanism
Inhibit ACE, reduce the conversion of Ang1 to Ang2, and relax blood vessels
Reduce aldosterone secretion and facilitate sodium excretion
Inhibits sympathetic nervous system activity
Inhibit bradykinin hydrolysis and increase bradykinin
clinical
One of the first-line drugs for the treatment of hypertension
Suitable for patients with hypertension, diabetes, insulin resistance, left ventricular hypertrophy, heart failure and acute myocardial infarction.
Enalapril
Long-acting, highly effective ACE inhibitor
mechanism.
Reduce total peripheral vascular resistance and increase renal blood flow
AT1 receptor blockers
Losartan
Selectively competes for AT1 receptors and antagonizes the pharmacological effects of angiotensin 2, thereby lowering blood pressure
Promote uric acid excretion
other drugs
sodium nitroprusside
Nitro vasodilators, NO donor drugs
mechanism
Directly relaxes arteriolar and venous smooth muscle
Produces NO in vascular smooth muscle, which has a powerful vasodilatory effect
clinical
Treatment of hypertensive emergencies
Controlled hypotension during surgical anesthesia
Hypertension combined with heart failure
Increased blood pressure due to pheochromocytoma attack
Adverse reactions - lupus erythematosus syndrome
New concepts in drug treatment of hypertension
Effective treatment and lifelong treatment
protect target organs
Smoothly reduce blood pressure
Combination medication