Classification of anti hypertensive drugs

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1. CLASSIFICATION OF ANTI- HYPERTENSIVE DRUGS JOHNY WILBERT, M.Sc [N ] LECTURER, APOLLO INSTITUTE OF HOSPITAL MANAGEMENT AND ALLIED SCIENCE

2. Definition The drugs used in the treatment of hypertension act by reducing the cardiac output and or reducing the total peripheral resistance, without correcting the cause.

3.  CLASSIFICATION :- 1)Drugs acting centrally . 2)Drugs acting on autonomic ganglia . 3)Drugs acting on the postganglionic sympathetic nerve ending . 4)Drugs acting on the adrenergic receptors .

4. 5)Drugs acting on the vascular smooth muscle. 6)Potassium channel activators. 7)Drugs which block renin-angiotensin-aldosterone axis. 8)Oral diuretics. 9)Miscellaneous.

5. Drugs acting centrally :- ( a)Alpha2 adrenergic receptorstimulants :- eg :- Clonidine and methyldopa ( b) Selective imidazole receptor (I-receptor) Stimulant:- eg :- Moxonidine  Drugs acting on the autonomicganglion :- Ganglion blocking agents eg :- Trimethaphan

6. Drugs acting on the postganglionic sympathetic nerve endings:- (a) Adrenergic neuron blockers eg :- Guaenethidine , Bethanidine , Debrisoquine , Bretylium . (b) Catecholamine depletors eg :- Reserpine

7. Drugs acting on adrenergic receptors :- ( a) Alpha-adrenergic blocking agents eg :- Phentolamine , Phenoxybenzamine , Prazosine , Indoramine . ( b) Beta-adrenergic blocking agents eg :- Propranol , Atenolol, Metopprolol . ( c) Both alpha and beta adrenergic blocking drugs eg :- Labetalol .

8. Drugs acting directly on the vascular smooth muscle:- ( a)Arteriolar vasodilators eg :- Calcium channel blockers, Hydralazine, Diazoxide , Minoxidil (b) Arteriolar- venular vasodilators eg :-Sodium nitroprusside Potassium channel activators:- eg :- Diazoxide , Minoxidil , Pinacidil , Nicorandil

9. Drugs which block renin-angiotensin- aldosterone axis:- ( a)Those which block renin release eg :- Beta-adrenergic blockers ( b) Those which block the conversion of angiotensin I to angiotensin II:- These drugs act by inhibiting the angiotensin converting enzyme (ACE) eg :- Captopril, Enalapril

10. (c) Those which competitively block angiotensin II vascular receptors (ARB): eg ;- Losartan . (d) Those which counterer the action of aldosterone ( Aldosterone antagonist):- eg :- Spironolactone .

11. Oral diuretics:- eg :- Thiazides Miscellaneous :- eg :- Metyrosine It must be emphasized that various antihypertensive drugs may ultimately reduce BP in humans by more than one mechanism.

12. Thank you