Classification of Antihypertensive Drugs
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Questions and Answers

What is the primary mechanism of action of calcium channel blockers?

  • Block potassium channels
  • Block calcium channels (correct)
  • Increase heart rate and contractility
  • Increase peripheral resistance

    • What is a common side effect of thiazide diuretics?

  • Hyperkalemia
  • Hypercalcemia
  • Hypokalemia (correct)
  • Hypermagnesemia

    • Which type of diuretic can cause hyperkalemia?

  • Osmotic diuretics
  • Thiazide diuretics
  • Potassium-sparing diuretics (correct)
  • Loop diuretics

    • What is a common side effect of beta blockers?

    <p>Bradycardia</p> Signup and view all the answers

    Which type of calcium channel blocker is more selective to the heart?

    <p>Non-Dihydropyridine</p> Signup and view all the answers

    What is a common interaction between verapamil and other medications?

    <p>Increased toxicity with lidocaine</p> Signup and view all the answers

    What is the primary mechanism of action of beta blockers?

    <p>Block β1-receptors</p> Signup and view all the answers

    Which type of diuretic is Frusemide an example of?

    <p>Loop diuretic</p> Signup and view all the answers

    What is a common side effect of calcium channel blockers?

    <p>Ankle swelling</p> Signup and view all the answers

    Which type of alpha blocker is Prazosin an example of?

    <p>α1-adrenergic blocker</p> Signup and view all the answers

    What is the primary mechanism of action of Angiotensin Converting Enzyme Inhibitors (ACEIs) on blood pressure regulation?

    <p>Inhibit Angiotensin II to prevent vasoconstriction</p> Signup and view all the answers

    Which of the following is a characteristic of Angiotensin Converting Enzyme Inhibitors (ACEIs) that makes them safe to use in patients with ischemic heart disease?

    <p>They do not cause reflex tachycardia</p> Signup and view all the answers

    What is the primary mechanism of action of Diuretics on blood pressure regulation?

    <p>Decrease blood volume by increasing urine output</p> Signup and view all the answers

    Which of the following is a common adverse effect of Angiotensin Converting Enzyme Inhibitors (ACEIs)?

    <p>Dry cough</p> Signup and view all the answers

    Which of the following is a characteristic of Angiotensin Receptor Blockers (ARBs)?

    <p>They block the action of angiotensin II on AT1 receptors</p> Signup and view all the answers

    Which of the following antihypertensive drugs is classified as a first-line or primary drug?

    <p>Angiotensin Converting Enzyme Inhibitors (ACEIs)</p> Signup and view all the answers

    What is the effect of Angiotensin Converting Enzyme Inhibitors (ACEIs) on bradykinin?

    <p>Increase bradykinin</p> Signup and view all the answers

    Which of the following is a contraindication for the use of Angiotensin Converting Enzyme Inhibitors (ACEIs)?

    <p>Pregnancy</p> Signup and view all the answers

    What is the effect of Angiotensin Converting Enzyme Inhibitors (ACEIs) on peripheral resistance?

    <p>Decrease peripheral resistance</p> Signup and view all the answers

    Which of the following is a mechanism of action of Angiotensin Converting Enzyme Inhibitors (ACEIs) on blood pressure regulation?

    <p>Inhibit the conversion of angiotensin I to angiotensin II</p> Signup and view all the answers

    What is the primary mechanism of action of organic nitrates?

    <p>Generation of NO leading to vasorelaxation</p> Signup and view all the answers

    Which type of adrenergic drug is clonidine?

    <p>α2- agonist</p> Signup and view all the answers

    What is the effect of arteriodilators on cardiac work?

    <p>Decrease O2 demand</p> Signup and view all the answers

    What is the main aim of treating heart failure?

    <p>Decrease symptoms</p> Signup and view all the answers

    Which type of drug is used to treat pregnant hypertensive patients?

    <p>α-Methyldopa</p> Signup and view all the answers

    What is the common side effect of β-blockers?

    <p>Dizziness, weakness, headache, impotence</p> Signup and view all the answers

    What is the effect of Ca++ channel blockers on cardiac oxygen demand?

    <p>Decrease cardiac oxygen demand</p> Signup and view all the answers

    What is the effect of venodilators on cardiac work?

    <p>Decrease cardiac work</p> Signup and view all the answers

    Which type of drug is used to treat variant angina?

    <p>Ca++ channel blocker</p> Signup and view all the answers

    What is the common side effect of Ca++ channel blockers?

    <p>Arterial dilation → headache, flushing, dizziness &amp; ankle edema</p> Signup and view all the answers

    What is the primary mechanism of action of Angiotensin Converting Enzyme Inhibitors (ACEIs) that helps reduce blood pressure?

    <p>Increase bradykinin levels</p> Signup and view all the answers

    Which of the following is a characteristic of Angiotensin Receptor Blockers (ARBs)?

    <p>They are classified as first-line or primary drugs</p> Signup and view all the answers

    What is the effect of Diuretics on blood pressure regulation?

    <p>Decrease blood volume</p> Signup and view all the answers

    What is a common adverse effect of Angiotensin Converting Enzyme Inhibitors (ACEIs)?

    <p>All of the above</p> Signup and view all the answers

    Which of the following is a contraindication for the use of Angiotensin Converting Enzyme Inhibitors (ACEIs)?

    <p>Pregnancy</p> Signup and view all the answers

    What is the effect of Angiotensin Converting Enzyme Inhibitors (ACEIs) on peripheral resistance?

    <p>Decrease peripheral resistance</p> Signup and view all the answers

    What is the primary mechanism of action of Diuretics?

    <p>Decrease blood volume</p> Signup and view all the answers

    What is the effect of Angiotensin Converting Enzyme Inhibitors (ACEIs) on cardiac output?

    <p>No effect on cardiac output</p> Signup and view all the answers

    Which of the following is a classification of Antihypertensive Drugs?

    <p>Diuretics, RAAS Inhibitors, Calcium Channel Blockers, and Sympatholytic Drugs</p> Signup and view all the answers

    What is the primary mechanism of action of Angiotensin Converting Enzyme Inhibitors (ACEIs) on blood pressure regulation?

    <p>Inhibit angiotensin II, increase bradykinin, and inhibit aldosterone</p> Signup and view all the answers

    What is the primary mechanism of action of thiazide diuretics?

    <p>Not mentioned in the text</p> Signup and view all the answers

    What is the effect of calcium channel blockers on heart rate?

    <p>Decrease heart rate</p> Signup and view all the answers

    Which of the following is a side effect of verapamil?

    <p>Both A and B</p> Signup and view all the answers

    What is the primary mechanism of action of beta blockers?

    <p>Blocking beta receptors</p> Signup and view all the answers

    What is the effect of calcium channel blockers on peripheral resistance?

    <p>Decrease peripheral resistance</p> Signup and view all the answers

    Which of the following is a side effect of frusemide?

    <p>Hypokalemia</p> Signup and view all the answers

    What is the primary mechanism of action of alpha blockers?

    <p>Blocking alpha receptors</p> Signup and view all the answers

    What is the effect of beta blockers on cardiac work?

    <p>Decrease cardiac work</p> Signup and view all the answers

    Which of the following is a side effect of amlodipine?

    <p>Ankle swelling</p> Signup and view all the answers

    What is the primary mechanism of action of spironolactone?

    <p>Sparing potassium</p> Signup and view all the answers

    What is the primary mechanism of action of organic nitrates?

    <p>Generation of NO leading to vasorelaxation</p> Signup and view all the answers

    Which type of drug is used to treat benign prostate hyperplasia (BPH)?

    <p>ɑ1a-blocker, such as Tamsulosin</p> Signup and view all the answers

    What is the effect of arteriodilators on cardiac work?

    <p>Decrease cardiac work</p> Signup and view all the answers

    Which type of drug is used to treat variant angina?

    <p>Calcium Channel Blocker, such as Nifedipine</p> Signup and view all the answers

    What is the effect of venodilators on cardiac work?

    <p>Decrease cardiac work</p> Signup and view all the answers

    What is the primary mechanism of action of β-blockers in reducing anginal pain?

    <p>Blockade of β1 receptors</p> Signup and view all the answers

    What is the effect of Ca++ channel blockers on cardiac oxygen demand?

    <p>Decrease cardiac oxygen demand</p> Signup and view all the answers

    Which type of drug is used to treat pregnant hypertensive patients?

    <p>Methyldopa, an ɑ2-agonist</p> Signup and view all the answers

    What is the main aim of treating heart failure?

    <p>Decrease the symptoms</p> Signup and view all the answers

    Which type of drug is used to treat hypertension?

    <p>Centrally acting adrenergic drug, such as Clonidine</p> Signup and view all the answers

    Study Notes

    Classification of Antihypertensive Drugs

    • Diuretics
    • Renin-Angiotensin-Aldosterone (RAAS) System Inhibitors:
      • Angiotensin Converting Enzyme Inhibitors (ACEI)
      • Angiotensin Receptor Blockers (ARB)
      • Renin inhibitors (e.g., aliskiren)
    • Calcium Channel Blockers (CCBs)
    • Sympatholytic Drugs
    • Direct Vasodilators (DVD)

    First-Line and Second-Line Antihypertensive Drugs

    • First-line (primary) drugs:
      • Angiotensin Converting Enzyme Inhibitors (ACEIs)
      • Angiotensin Receptor Blockers (ARBs)
      • Calcium Channel Blockers (CCBs)
      • Diuretics
    • Second-line (alternative) drugs:
      • Alpha blockers
      • Beta Blockers
      • Central α2 agonists
      • Vasodilators

    ACE Inhibitors and Angiotensin Receptor Blockers (ARBs)

    • Mechanism of action:
      • Inhibit Angiotensin II, preventing vasoconstriction
      • Increase bradykinin, causing vasodilation
      • Diuresis, inhibiting aldosterone
    • Decrease BP by decreasing PR, without affecting CO or HR
    • Unlike direct vasodilators, they do not cause reflex tachycardia
    • Examples:
      • ACE-inhibitors: Enalapril, Ramipril, and Captopril
      • AT1 receptor antagonists (ARBs): Losartan and Valsartan
    • Pharmacokinetics: Eliminated primarily by the kidneys; adjust dose in renal insufficiency
    • Adverse effects:
      • Dry cough (5-30%)
      • Angioedema
      • Hyperkalemia
      • Teratogenic (not used in pregnancy)

    Diuretics

    • Mechanism of action:
      • Diuretic action decreases blood volume
      • Decrease cardiac output
      • Decrease blood pressure
    • Classification:
      • Thiazide diuretics: Hydrochlorothiazide
      • Loop diuretics: Frusemide
      • Potassium-sparing diuretics: Spironolactone, Triamterene
    • Adverse effects:
      • Hypokalemia
      • Hypomagnesemia
      • Hyperkalemia (in case of potassium-sparing diuretics)
      • Hyponatremia and hypercalcemia (Thiazide)
      • Hyperurecemia
      • Hyperglycemia

    Calcium Channel Blockers (CCBs)

    • Mechanism of action:
      • Block calcium channels
      • Decrease heart rate and contractility in the heart
      • Vasodilation in blood vessels
    • Examples:
      • Non-Dihydropyridine: Diltiazem and Verapamil (more selective to the heart)
      • Dihydropyridine: Nifidipine and Amlodipine (more selective to blood vessels)
    • Adverse effects:
      • Flushing, headache, and tachycardia
      • Ankle swelling (edema) is common
      • Negative inotropic effect of verapamil (can worsen heart failure)
      • Constipation is common with verapamil

    Beta Blockers

    • Mechanism of action:
      • Act mainly by blocking β1 receptors
      • Decrease heart rate
    • Examples:
      • Non-selective β-blockers: Propranolol and Carvedilol
      • Selective β1-blockers: Atenolol and Bisoprolol
    • Adverse effects:
      • Bradycardia
      • Fatigue
      • Cold extremities
      • Erectile dysfunction
      • Bronchospasm (especially with non-selective β-blockers)

    Alpha Adrenergic Blockers

    • Examples: Prazosin, Doxazosin, Terazosin
    • Produce a competitive block of α1-adrenoceptors
    • Tamsulosin, an α1a-blocker, is used in the treatment of benign prostate hyperplasia (BPH)

    Centrally Acting Adrenergic Drugs

    • α2-agonist: Clonidine
    • α-Methyldopa: specially valuable in treating pregnant hypertensive patients

    Direct Vasodilators

    • Arteriodilators: Hydralazine, Minoxidil, Diazoxide
    • Venodilators: Nitroglycerine (IV infusion in hypertensive emergencies)
    • Arteriovenodilators: Sodium Nitroprusside

    Anti-Angina Drugs

    • Nitrites and Nitrates
    • Calcium Channel Blockers (CCBs)
    • Beta Blockers
    • Adjuvant drugs:
      • Anti-Platelet: Aspirin, Clopidogrel, and Ticlopidine
      • Drug treatment of risk and precipitating factors (e.g., Anxiolytic, Antihypertensive, Anti-hyperlipidemic, Anti-diabetic, etc.)

    Organic Nitrates

    • Mechanism of action:
      • Generation of NO leading to vasorelaxation
    • Cardiovascular effects:
      • Increase O2 supply and decrease cardiac work (decrease O2 demand) by VD
    • Side effects:
      • Venodilation → Postural hypotension, reflex tachycardia, dizziness, and syncope
      • Arteriodilation → Throbbing headache and flushing
      • Tolerance

    Classification of Antihypertensive Drugs

    • Diuretics
    • Renin-Angiotensin-Aldosterone (RAAS) System Inhibitors:
      • Angiotensin Converting Enzyme Inhibitors (ACEI)
      • Angiotensin Receptor Blockers (ARB)
      • Renin inhibitors (e.g., aliskiren)
    • Calcium Channel Blockers (CCBs)
    • Sympatholytic Drugs
    • Direct Vasodilators (DVD)

    First-Line and Second-Line Antihypertensive Drugs

    • First-line (primary) drugs:
      • Angiotensin Converting Enzyme Inhibitors (ACEIs)
      • Angiotensin Receptor Blockers (ARBs)
      • Calcium Channel Blockers (CCBs)
      • Diuretics
    • Second-line (alternative) drugs:
      • Alpha blockers
      • Beta Blockers
      • Central α2 agonists
      • Vasodilators

    ACE Inhibitors and Angiotensin Receptor Blockers (ARBs)

    • Mechanism of action:
      • Inhibit Angiotensin II, preventing vasoconstriction
      • Increase bradykinin, causing vasodilation
      • Diuresis, inhibiting aldosterone
    • Decrease BP by decreasing PR, without affecting CO or HR
    • Unlike direct vasodilators, they do not cause reflex tachycardia
    • Examples:
      • ACE-inhibitors: Enalapril, Ramipril, and Captopril
      • AT1 receptor antagonists (ARBs): Losartan and Valsartan
    • Pharmacokinetics: Eliminated primarily by the kidneys; adjust dose in renal insufficiency
    • Adverse effects:
      • Dry cough (5-30%)
      • Angioedema
      • Hyperkalemia
      • Teratogenic (not used in pregnancy)

    Diuretics

    • Mechanism of action:
      • Diuretic action decreases blood volume
      • Decrease cardiac output
      • Decrease blood pressure
    • Classification:
      • Thiazide diuretics: Hydrochlorothiazide
      • Loop diuretics: Frusemide
      • Potassium-sparing diuretics: Spironolactone, Triamterene
    • Adverse effects:
      • Hypokalemia
      • Hypomagnesemia
      • Hyperkalemia (in case of potassium-sparing diuretics)
      • Hyponatremia and hypercalcemia (Thiazide)
      • Hyperurecemia
      • Hyperglycemia

    Calcium Channel Blockers (CCBs)

    • Mechanism of action:
      • Block calcium channels
      • Decrease heart rate and contractility in the heart
      • Vasodilation in blood vessels
    • Examples:
      • Non-Dihydropyridine: Diltiazem and Verapamil (more selective to the heart)
      • Dihydropyridine: Nifidipine and Amlodipine (more selective to blood vessels)
    • Adverse effects:
      • Flushing, headache, and tachycardia
      • Ankle swelling (edema) is common
      • Negative inotropic effect of verapamil (can worsen heart failure)
      • Constipation is common with verapamil

    Beta Blockers

    • Mechanism of action:
      • Act mainly by blocking β1 receptors
      • Decrease heart rate
    • Examples:
      • Non-selective β-blockers: Propranolol and Carvedilol
      • Selective β1-blockers: Atenolol and Bisoprolol
    • Adverse effects:
      • Bradycardia
      • Fatigue
      • Cold extremities
      • Erectile dysfunction
      • Bronchospasm (especially with non-selective β-blockers)

    Alpha Adrenergic Blockers

    • Examples: Prazosin, Doxazosin, Terazosin
    • Produce a competitive block of α1-adrenoceptors
    • Tamsulosin, an α1a-blocker, is used in the treatment of benign prostate hyperplasia (BPH)

    Centrally Acting Adrenergic Drugs

    • α2-agonist: Clonidine
    • α-Methyldopa: specially valuable in treating pregnant hypertensive patients

    Direct Vasodilators

    • Arteriodilators: Hydralazine, Minoxidil, Diazoxide
    • Venodilators: Nitroglycerine (IV infusion in hypertensive emergencies)
    • Arteriovenodilators: Sodium Nitroprusside

    Anti-Angina Drugs

    • Nitrites and Nitrates
    • Calcium Channel Blockers (CCBs)
    • Beta Blockers
    • Adjuvant drugs:
      • Anti-Platelet: Aspirin, Clopidogrel, and Ticlopidine
      • Drug treatment of risk and precipitating factors (e.g., Anxiolytic, Antihypertensive, Anti-hyperlipidemic, Anti-diabetic, etc.)

    Organic Nitrates

    • Mechanism of action:
      • Generation of NO leading to vasorelaxation
    • Cardiovascular effects:
      • Increase O2 supply and decrease cardiac work (decrease O2 demand) by VD
    • Side effects:
      • Venodilation → Postural hypotension, reflex tachycardia, dizziness, and syncope
      • Arteriodilation → Throbbing headache and flushing
      • Tolerance

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    Antihypertensive Drugs Classification Note PDF

    Description

    This quiz covers the classification of antihypertensive drugs, including diuretics, RAAS inhibitors, calcium channel blockers, sympatholytic drugs, and direct vasodilators.

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