hypertensives drugs

diuretic
inhibit reabsorption of Na+ and Cl- in distal tubule
increase absorption of Ca
causes water retention

thiazides

vasodilator, can tx kidney stones (*reduction of calcium in urine*)

hypokalemia, hypercalcemia, gout, hyperglycemia, photosensitivity

potassium sparing diuretic
aldosterone receptor antagonist
inhibit Na and K channels > increased Na excretion and decreased K excr
good use with K+ depleting agents

inhibit Na channels > inc excretion of Na, dec excr of K
NOT an aldosterone receptor antagonist like spironolactone

prevent loss of K+ from thiazide or loop diuretics

these are called potassium sparing diuretics

captopril, lisinopril, ~prils

ACE inhibitors!

inhibit angiotensin converting enzyme, dec production of angiotensin II
cause less vasoconstriction (dec sympathetic)
inc bradykinin levels (vasodilator)
less aldosterone production > less na/water retention

peptidyl dipeptidase

dry cough due to inc bradykinin
angioedema
dry mouth
glossitis
oral ulceration and bleeding

losartan; ~sartan

inc aldosterone, ADH, TPR, SNS

competitive antagonist of ATII type 1 receptors

for pts who cannot tolerate ACE inhibitors; less sfx
functions similar to ACEI

bind to L-type ca ch's, inhibit Ca influx into cardiac and arterial sm m cells

INHIBITION OF MUSCLE CONTRACTION > dilation of art > dec BP

verapamil, diltiazem

non-dihydrophyridine calcium channel blocker!

significant cardiac depression

non-dihydropyridine ccb!

similar to verapamil, depress cardiac and HR
actions on cardiac and vascular beds

nifedipine, amlodipine

dihydropyridine ccb!

arteriole vasodilation, little cardiac effect