Obat Antihipertensi
Obat Antihipertensi
Obat Antihipertensi
DRUGS
Hipertensi
Hipertension adalah penyakit kardiovascular yang
paling umum.
The prevalence varies with age, race, education,
and many other variables.
Sustained arterial hypertension damages blood
vessels in kidney, heart, and brain and leads to an
increased incidence of renal failure, coronary
disease, cardiac failure, and stroke.
Effective pharmacologic lowering of blood pressure
has been shown to prevent damage to blood vessels
and to substantially reduce morbidity and mortality
rates.
Lokasi anatomi yang
mengontrol tekanan Darah
Tekanan Darah Normal
BHS Classification of BP Levels
This classification equates with that of the WHO/ISH (2) and is based on clinical BP values. If SBP and DBP
fall into different categories the higher value should be taken for classification.
Suggested target blood pressures during antihypertensive treatment
Systolic and diastolic should both be attained eg <140/85 mmHg means less than 140 mmHg
systolic and less than 85 mmHg diastolic
Despite best practice, the Audit Standard will not be achievable in all treated hypertensives
Classification
1.Sympatholytics : a) Alpha 2 agonists
b) Alpha 1
antagonists
c) Beta blockers
d) Adrenergic neuron
blockers.
2.Diuretics
3.Angiotensin inhibitors
4.Vasodilators
5.Calcium channel blockers
Obat Hipertensi
Sympatholytics
a) Alpha 2 agonists : Alpha Methyl dopa,
Clonidine.
1)Alpha Methyl dopa : converted to
Alpha methyl NE, Activates alpha2
receptors in medulla. NE in vasomotor
centre of medulla PVR.
High 1st pass metabolism
Safe in Pregnancy and renal failure.
Side effects:Sedation, Prolactin
Lactation, Hemolytic anemia with
positive coombs test,drug fever,edema.
2)Clonidine: Alpha2 agonist in
vasomotor centre in medulla. PVR.
Uses:1. HTN 2.Rx of withdrawl
symptoms of Opiates(morphine)
Side effects:Dry mouth, sedation,
edema, Rebound HTN.
b) Alpha1 antagonists:
Prazocin,Doxazocin,Terazocin.
Competitively blocks alpha1 receptors
on arterioles and veins. NE action on blood
vessels PVR.
Uses : 1.HTN 2.Bening prostatic
hyperplasia.
Side effects:1st dose
syncope,orthostatic
hypotension,Edema,Reflex tachycardia.
C)Beta 1 antagonists.
Cardioselective beta blockers
CV effects: HR
cond.Velocity
contractility
.
Ex:Hydrochlorothiazide,Chlorothiazid
e,Chlorthalidone,Indapamide,Metolaz
one.
Side effects: 1.Hypokalemia
2.Metabolic alkalosis 3.Hyperuricemia
4.Hyponatremia 5.Hyperglycemia
6.Hyperlipidemia 7.Hypercalcemia.
8.Allergic reactions.