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In this article, the summary of antihypertensive drugs is explained briefly with their common therapeutic problems and side effects. Antihypertensives are the drugs for the management and treatment of hypertension or high blood pressure.
Diuretics
Examples
- Thiazides; Bendroflumethiazide
- loops; furosemide
- K sparing; spironolactone
Major adverse effects
- Hypokalemia
- Gout
- Glucose intolerance
- Hyperlipidemia
- Impotence
- Uraemia
- Dehydration
- Hyperkaliemia
- Gynecomastia
Diuretics are cheap, effective. However, they may have long term metabolic effects. Their use is more appropriate in older patients. Especially for patients with cardia failure and resistant hypertension.
Β- blockers
Examples
- Atenolol
- Propranolol
- Metoprolol
- Labetalol
- Celiprolol
Major side effects
- Tiredness
- Reduced exercise intolerance
- Bradycardia
- Cold peripheries
- Claudication
- Wheezing
- Cardiac failure
- Impotence
These hypertensive drugs are cheap in price with common adverse effects after their regular use. Moreover, they are less effective in preventing cardiovascular events. Such as , they are not more effective inpatients with ischemic heart disease.
Calcium antagonists; dihydropyridine
Examples
- Nifedipine
- Amlodipine
Side effects
- Flushing
- Oedema
- Postural hypertension
- Headache
These drugs are not well tolerated especially in early treatment. They can reduce the risk of stroke and myocardial infarction. In addition, their efficacy is like thiazides. However, they are administer to elderly patients with ischemic heart disease or diabetes.
Calcium antagonists; rate limiting
Examples
- Verapamil
- Diltiazem
Adverse effects
- Bradycardia/heart block
- Constipation due to verapamil only
These hypertensive drugs are well tolerating. In addition, they are more suitable for patients with ischemic disease who are unable to tolerate β blockers.
ACE inhibitors
Examples
- Captopril
- Analapril
- Lisinopril
- Perindopril
- Ramipril
Adverse effects
- Cough (very common)
- Rash
- Taste disturbance
- Renal failure
- Angioedema
ACE inhibitors are antihypertensive drugs that are more expensive. Its more suitable for patients with cardiac failure and diabetes and for younger patients.
α – blockers (alpha blockers)
Examples
- prazosin
- doxazosin
- terazosin
Adverse effects
- Oedema
- Postural hypertension
Alpha blockers are more expensive. They are second line of drugs because they are less effective than thiazides to prevent heart failure.
Angiotensin receptor blockers
Examples
- Losartan
- Valsartan
- Irbesartan
Adverse effects
- Renal failure
- Oedema
- Headache
These antihypertensive drugs are more expensive
Especially these are used when ACE inhibitors are not tolerated due to cough.
Centrally acting vasodilators
Examples
- Methyldopa
- Moxonidine
Adverse effects
- Tiredness
- Depression
These are third line of antihypertensive drugs. But ae used only in severe hypertension or in pregnancy hypertension.
Direct acting vasodilators
Examples
- Diazoxide
- Minoxidil
- Nitroprusside
Adverse effects
- Oedema
- Postural hypertension
- Headache
Only uses in severe hypertension because they are poorly tolerated drugs.
