Hypertension Drugs & Mechanisms PDF

## Hypertension Hypertension - Is the condition in which the force of blood pushing against the walls of blood vessels/the heart is too high. Its measured in mmHg, systolic- aorta / heart contaction Diastole- during relaxation. Normal = 120/80 mmHg. ### Primary Hypertension - The one with no id...

## Hypertension Hypertension - Is the condition in which the force of blood pushing against the walls of blood vessels/the heart is too high. Its measured in mmHg, systolic- aorta / heart contaction Diastole- during relaxation. Normal = 120/80 mmHg. ### Primary Hypertension - The one with no identifiable cause. - Risk factors, obesity - Age - Genetics - Sedentary lifestyle ### Secondary Hypertension - It can be identifiable cause. - Risk factors, snoring - Stress - Anxiety ## Drugs in Hypertension ### RAAS Inhibitor We first need to understand the RAAS. - **Angiotensin II** - Vasoconstriction - Vascular smooth muscle contraction - Juxtaglomerular apparatus - Release of ADH - Renin - Increase TBP - Increase peripheral vasoconstriction - Increase renal reabsorption of sodium - Increase H2O reabsorption - Increase aldosterone - Increase BP - Decrease excretion of potassium - Hypokalaemia - **Angiotensinogen** - Liver - **Renin** - Kidney - **Angiotensin I** - **ACE -** Bradikinin - vasoactive peptide - Vasodilation - More relaxation - Increase permeability of pain during a mammography ## ACE Inhibitors ACE- Angiotensin Converting Enzyme / ARBS- Angiotensin II Receptor Blocker - These are drugs that block ACE - Ang I - Ang II - They are called "the pils" coz they end it "pil" - Ex. Ranipil - Captopil - Peridopat - Lisinopril ### Normally ACE; - Increase Angiotensin II - vasoconstriction - Increase peripheral vascular resistance - Increase TBP - Decrease Bradykinin ### MOA - ACE inhibitors - Increase ACE - Increase Angiotensin II - Increase Bradykinin - Vasodilation. - Vasoconstriction - Decrease peripheral vascular resistance - Decrease TBP - ARBF - for renal injury. ### Side effects. - Dry cough (due to accumulation of bradykinin) - it irritates nerve endings of reep. - Hyperkalemia (because aldosterone won't be there to excrete K+ ions) - Angioedema (Bradykinin ↑ vascular permeability) - so water leaks out into interstitium = edema ### Indications - Hypertension - Heart Failure ### Contra indications - Pregnancy - Hyperkalemia ## Angiotensin II Receptor Blockers "ARB's"- the Sartans As the name suggests, these drugs block Angiotensin II receptors (AT 1) - in the blood vessels - vasodilation - Decrease peripheral vascular resistance. - in the 2G - Increase aldosterone - Increase Na+ reabsorption ### MOA - Block AT 1 in 2G - Increase aldosterone - Increase Na+ reabsorption. - No effect on B - V vasodilation - Decrease peripheral vascular resistance - Decrease TBP - TRBF = low renal injury ### Side effects. - Natriuresis. - Hyperkalemia - Leg swelling (pericheal edema) - Dizziness - Headaches ### Names - Losartan - Candesartan - Telmisartan