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    HYPERTENSION Priya FINAL PPT 2

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    Priya Tiwari
    This document provides information about antihypertensive drugs. It defines hypertension and describes the types as primary or secondary. It discusses the causes, risks, and classification of antihypertensive drugs. The classifications include ACE inhibitors, angiotensin II receptor blockers, calcium channel blockers, diuretics, sympatholytics, direct renin inhibitors, vasodilators. It provides details on the mechanisms and structures of these drug classes.

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    HYPERTENSION Priya FINAL PPT 2

    Uploaded by

    Priya Tiwari
    117 views14 pages
    This document provides information about antihypertensive drugs. It defines hypertension and describes the types as primary or secondary. It discusses the causes, risks, and classification of antihypertensive drugs. The classifications include ACE inhibitors, angiotensin II receptor blockers, calcium channel blockers, diuretics, sympatholytics, direct renin inhibitors, vasodilators. It provides details on the mechanisms and structures of these drug classes.

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    HYPERTENSION

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    HYPERTENSION priya FINAL PPT 2

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    This document provides information about antihypertensive drugs. It defines hypertension and describes the types as primary or secondary. It discusses the causes, risks, and classification of antihypertensive drugs. The classifications include ACE inhibitors, angiotensin II receptor blockers, calcium channel blockers, diuretics, sympatholytics, direct renin inhibitors, vasodilators. It provides details on the mechanisms and structures of these drug classes.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    117 views14 pages

    HYPERTENSION Priya FINAL PPT 2

    Uploaded by

    Priya Tiwari
    This document provides information about antihypertensive drugs. It defines hypertension and describes the types as primary or secondary. It discusses the causes, risks, and classification of antihypertensive drugs. The classifications include ACE inhibitors, angiotensin II receptor blockers, calcium channel blockers, diuretics, sympatholytics, direct renin inhibitors, vasodilators. It provides details on the mechanisms and structures of these drug classes.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 14

    SLT INSTITUTE OF PHARMACEUTICAL SCIENCES

    GURU GHASIDAS VISHWAVIDYALAYA

    DEPARTMENT OF PHARMACY

    SEMINAR ON
    ANTI-HYPERTENSIVE DRUGS

    SUBJECT: ADVANCED MEDICINAL CHEMISTRY


    SUBMITTED TO : Dr HARISH RAJAK SIR

    SUBMITTED BY : PRIYA TIWARI


    M.PHARMA 1ST SEMESTER
    ROLL NO: 20703007
    ENROLLMENT NO : 06332
    HYPERTENSION
    • HYPERTENSION IS A COMMON CVS DISEASE AFFECTING WORLDWIDE POPULATION. A PERSISTENT
    AND SUSTAINED HIGH BLOOD PRESSURE HAS DAMAGING EFFECTS ON THE HEART , BRAIN ,
    KIDNEYS AND EYES.
    • It is one of the common cardiovascular disorders and it is a state of the body in which the systolic blood
    pressure (BP) is 150 mm Hg or more and diastolic BP is 95 mm Hg or more.(normal BP
    • 120/80
    PRIMARY HYPERTENSION
    It is other wise known as essential hypertension. It is
    characterized by the following:
    Primary • Elevation of diastolic BP.
    • Normal cardiac output.
    Types of • An increase in peripheral resistance.
    Hypertension SECONDARY HYPERTENSION
    Factors causing secondary hypertension are as follows:
    Secondary • Acute or chronic renal disease.
    • Hyperaldosteronism.
    • Cushing’s syndrome.
    • Acromegaly.
    • Pheochromocytoma.
    • Oral contraceptives, steroids, estrogen, and
    sympathomimetics.
    CAUSES OF HYPERTENSION RISKS OF HYPERTENTION
    ANTIHYPERTENSIVE
    CLASSIFICATION
    1. Angiotensin converting enzyme (ACE) inhibitors
    Captopril, enalapril , ramipril , lisinopril ,
    2. Angiotensin II receptor blockers ACE Inhibitors
    Losartan , candesartan , telmisartan
    3. Direct renin inhibitors
    Aliskiren Angiotensin II
    4. Calcium channel blockers Sympatholytics Receptor
    blockers
    Diltiazem, verapamil , nifedipine , amlodipine ,
    5. Diuretics
    a) Thiazides – hydrochlorothiazide Antihypertensive On
    b) Loop Diuretics – furosemide , bumetanide The basis of
    c) Potassium Sparing Diuretics – amiloride , therapeutic action
    triamterene
    spironolactone
    6. Sympatholytics Diuretics
    d) Centrally acting – Clonidine , α-methyldopa Direct renin
    e) Βeta-Adrenergic blockers- atenolol, metoprolol , esmolol, inhibitors
    betaxolol, timolol, propranolol.
    Calcium channel
    f) Β-Adrenergic blockers with α blocking activity blockers
    Labetalol , Carvedilol
    d) α adrenergic blockers : prazocin , terazocin

    7. Vasodilators – Minoxidil , Hydralazine , Glyceryl trinitrate


    ACE INHIBITORS AND
    HYPERTENSION

    ACE inhibitors work by interfering with the body's


    renin-angiotensin-aldosterone system (RAAS). RAAS is
    a complex system responsible for regulating the body's
    blood pressure. The kidneys release an enzyme called
    renin in response to low blood volume, low salt
    (sodium) levels or high potassium levels
    1st choice of drug in all grades of hypertension except in bilateral
    renal stenosis
    Advantages:
    1. No electrolyte imbalance (no fatigue or weakness) or postural
    hypotension
    2. No hyperuricemia or deleterious effect on plasma lipid profile
    3. Safe in diabetics and asthmatics
    4. performance etc.
    ANGIOTENSIN RECEPTOR
    BLOCKERS
    Angiotensin II receptor blockers (ARBs) are medications
    that block the action of angiotensin II by
    preventing angiotensin I from binding
    to angiotensin II receptors on the muscles surrounding
    blood vessels. As a result, blood vessels enlarge (dilate)
    and blood pressure is reduced
    But, combination therapy: Total suppression of RAS
    1. A-II generate by non ACEW mechanisms – ARBs block
    2. ACEIs produce bradykinin related vasodilatation –
    CALCIUM CHANNEL
    BLOCKERS
    Calcium channel blockers lower your blood pressure by
    preventing calcium from entering the cells of your heart
    and arteries. Calcium causes the heart and arteries to
    contract more strongly. By blocking calcium, calcium
    channel blockers allow blood vessels to relax and open.

    • Verapamil, diltiazem, nifedipine and amlodipine etc.


    • advantages:
    • No hemodynamic effect – physical work capacity
    • No effect on lid profile, uric acid
    • They lower BP by decreasing peripheral resistance
    without compromising cardiac output
    DIURETICS – MOA
    Mechanism of antihypertensive action:
    Diuretics help rid your body of sodium and
    water. Most work by making your kidneys
    release more sodium into the urine. The sodium
    then takes water with it from your blood
    decreasing the amount of fluid flowing through
    your blood vessels hence lowering blood
    pressure.
    Initially: diuresis- depletion of Na+ and body fluid volume
    _decrease in cardiac output
    Drugs causing net loss of Na+ and water in urine .
    MECHANISM
    STRUCTURES
    BETA –ADRENERGIC BLOCKERS

    • Non selective: Propranolol (others: nadolol timolol, pindolol and


    labetolol ) and Cardio selective: Metoprolol (others: atenolol,
    acebutalol, esmolol, betaxolol)
    • All beta-blockers similar antihypertensive effects:
    • Reduction in CO but no change in BP initially but slowly- adaptation
    • Beta blockers work by blocking the effects of the
    hormone epinephrine, also known as adrenaline. Beta
    blockers cause your heart to beat more slowly and with
    less force, which lowers blood pressure. Beta
    blockers also help open up your veins and arteries to
    improve blood flow.
    CENTRALLY ACTING ANTIHYPERTENSIVES 
    The classic centrally acting antihypertensives such as
    clonidine, guanfacine and alpha-methyl-DOPA (via its active
    metabolite alpha-methyl-noradrenaline) induce peripheral
    sympathoinhibition and a fall in blood pressure as a result of
    alpha2-adrenoceptor stimulation in the brain stem

    Renin inhibitors
    Renin inhibitors are pharmaceutical drugs inhibiting the
    activity of renin that is responsible for hydrolyzing
    angiotensinogen to angiotensin I, which in turn reducing the
    formation of angiotensin II that facilitates blood pressure. ALISKIREN

    VASODILATORS
    Vasodilators. As the name implies, vasodilator drugs relax
    the smooth muscle in blood vessels, which causes the
    vessels to dilate. Dilation of arterial (resistance) vessels
    leads to a reduction in systemic vascular resistance, which
    leads to a fall in arterial blood pressure.
    CLASS MECHANISM
    ANTIHYPERTENSIVES AVOIDED DURING PREGNANCY

    Ace inhibitors
    Diuretics
    Nonselective beta blockers
    Sod nitoprusside

    ANTIHYPERTENSIVES SAFE DURING PREGNANCY

    Methyldopa
    Calcium channel blocker-(not in labour)
    Cardiselective beta blocker- atenolol, metoprolol,pindolol
    Prazocin and clonidine
    THANK YOU

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