Intravenous Agents –Tx Hypertension

Diazoxide
 Enalaprilat
 Esmolol
 Fenoldopam
 Hydralazine
 Labetalol
 Nicardipine
 Nitroglycerin, intrav

Oral Agents

Captopril Clonidine Nifedipine

Therapeutic Summary of Selected Drugs used to Treat Hypertension

DRUGS CLINICAL APPLICATIONS ADVERSE EFFECTS CONTRAINDICATIONS

Mechanism: Inhibits sodium reabsorption in the distal tubules; increases excretion of sodium, water, potassium and hydrogen ion

Thiazide-type diuretics

Hydrochlorothiazide Chlorthalidone Indapamide Metolazone

Management of mild to moderate hypertension

Treatment of edema in congestive heart failure and nephrotic syndrome

Hyponatremia Hypokalemia (except

with potassium-

sparing diuretics) Hyperuricemia Sexual dysfunction Hyperglycemia Hyperlipidemia

Sulfonamide hypersensitivity Pregnancy
 Anuria

Mechanism: b-Receptor antagonists

Atenolol Metoprolol Nadolol Propranolol Timolol
 Releases nitric oxide Nebivolol

Also block alpha receptors

Labetalol Carvedilol

Hypertension
 Angina
 Supraventricular arrhythmias Migraine headache (propranolol) Essential tremor
 Glaucoma (timolol)

AV block Bronchospasm Sedation
 Wheezing
 Mask hypoglycemia

Lung disease Cardiogenic shock Heart block

Mechanism: a1-Receptor antagonists

Doxazosin Prazosin Terazosin

Hypertension
 Benign prostatic hyperplasia (BPH)

First-dose postural hypotension

Nasal congestion Hepatotoxicity Pancreatitis

Concurrent use with phosphodiesterase-5 (PDE-5) inhibitors such as sildenafil

Mechanism: a2-Receptor agonists; centrally acting

Clonidine Methyldopa

Hypertension
 CNS effects (clonidine)

Bradycardia
 Dry mouth Constipation
 Sedation
 Autoimmune hemolytic

anemia (methyldopa)

Hypersensitivity
 Hepatic disease (methyldopa)

Mechanism: Calcium channel blockers

Amlodipine Diltiazem Nifedipine Verapamil

Hypertension Angina pectoris Atrial fibrillation Atrial fluter

Peripheral edema Hypersensitivity Constipation Heart failure Headache

Mechanism: Angiotensin-converting enzyme (ACE) inhibitors; decrease preload afterload and cardiac remodeling

Benazepril Captopril Enalapril Fosinopril Lisinopril Moexipril Perindopril Quinapril Ramipril Trandolapril

Hypertension Diabetic nephropathy Heart failure
 Post-MI

Dry hacking cough Angioedema Hyperkalemia Hypotension

Hypersensitivity Pregnancy