1Pathophysiology of Hypertension
Increased Total Peripheral Resistance (TPR)
Renin-Angiotensin-Aldosterone System (RAAS) Dysregulation
Sympathetic Nervous System (SNS) Overactivity
Kidney Dysfunction and Sodium/Volume Handling
2Drug preferred in parients with hyperaldosternoism and hypertension
Spironolactone
3Drug preferred in patients with Pheochromocytoma with hypertension
Phenoxybenzamine
4Drug preferred in patients with Heart problems
Beta blockers—>Avoid asthma —>CCB non DHP type(Verampamil,Dilitiazem)
5Drugs given to patients with peripheral vascular disease with hypertension
CCB- DHP type
6Drug given to patients with Diabetes mellitus and hypertesnion
ACE Inhibitors —>ARBs
7Function of bradykinin
Bradykinin is a peptide which causes vasodilation due to release of NO and prostacyclin
8Chronic hypertension in pregnancy—>DOC
Alpha methyldopa,Labetalol
9Pregnancy induced hypertension DOC
Labetalol—>Hydralazine —>Nifedipine
10Hypertensive urgency
No organ damage/Impending organ damage —>Oral clonidine/Labetalol
11Hypertensive emergency
End organ damage —>Nicardipine
12Explain how sympathetic nervous system overactivity causes hypertension
Sympathetic nervous sytem releases nor epinephrine which affects the beta 1 receptors in heart which leads to opening of calcium channels and finally reduced cardiac output and increased systolic blood pressure
The nor epinephrine affects the alpha 1 receptors of blood vessels which lead to vasoconstriction and inscreased diastolic blood pressure
Similarly nor epinephrine affects the beta 1 receptors of kidney which affects the JG cells which releases renin —>Activates RAAS which reduces diuresis and increases blood volume
13What are thwvclassification of drugs used for hypertension
Sympatholytic
Diuretics
RAAS Inhibitors
Ca channel blockers
Vasodilators
14Types of Sympatholytics
1.Centrally acting sympatholytics —>Clonidine,Alpha methyldopa
2.Adrenergic neuron blockers —>Reserpine ,Guanethidine—> Decreases cardiac output,Vasodilation,decreases renin release
SE: Severe postural hypertension
3.Beta blockers—> lol —> Decreases cardiac output and renin release
4.Alpha blockers —>Vasodilation
15How diuretics help in hypertension
Diuretics, often called "water pills," are a cornerstone of hypertension treatment. They primarily help lower blood pressure by reducing the volume of fluid in the body and by causing blood vessel relaxation
Thiazide diuretics are preferred
16TYPES OF HYPERTENSION
Primary hypertension—>Essential hypertension[Idiopathic]
Secondary hypertension—>Hypertension +Comorbidity
Hypertension with pregnancy
Hypertensive crisis
17First line drugs for essential hypertension
ACE INHIBITORS /ARBs
CCB DHP type
Thiazide diuretics
18Which drug is preferred in a patient with hypertension and benign prostat
Prasozin —>Alpha blocker
19What is the mechanism of action for Diuretics?
They help the kidneys remove excess sodium and water, reducing blood volume and pressure.
20What common side effect is associated with ACE Inhibitors?
A persistent, dry cough (due to increased bradykinin).
21What is the full name for ACE Inhibitors?
Angiotensin-Converting Enzyme Inhibitors
22How do ACE Inhibitors lower blood pressure?
By preventing the conversion of angiotensin I to angiotensin II (a potent vasoconstrictor).
23What is the primary action of Angiotensin II Receptor Blockers (ARBs)?
They block the action of angiotensin II at its receptor sites, leading to vasodilation and reduced blood pressure.
24What drug class is often contraindicated in pregnant women due to potential teratogenic effects?
ACE Inhibitors (and ARBs).
25How do Beta-blockers lower blood pressure?
They block the effects of adrenaline on the heart, reducing heart rate and cardiac output.
26What is the mechanism of action for Calcium Channel Blockers (CCBs)?
They prevent calcium from entering the heart muscle cells and arteries, causing vasodilation and lowering blood pressure.
27What are two examples of Calcium Channel Blockers?
Amlodipine and Diltiazem (or Verapamil, Nifedipine).
28Which class of diuretic is often referred to as "water pills" and is commonly used with other medications?
Thiazide Diuretics (like Hydrochlorothiazide/HCTZ).
29Side effects of CCBs
Dizziness,Headache,Flushing,Peripheral edema,Gingival hyperplasia
30Side effects of DHPs
Bradycardia
Verapamil—>Constipation
31Side effects of RAAS inhibitors
Hyperkalemia(Due to aldosterone level)