THERAPEUTIC NDICATIONS APPROVED CALCIUM CHANNEL BLOCKERS HYPERTENSION rapamil Diltiazem Nifedipine Felodipine Isradipine Amlodipine Nicardipine ANGINA VerapamilDiltiazem Nifedipine Amlodipine Nicardipine SUPRAVENTRICULAR TACHYARRHYTHMIA apamil Diltiazem SAFE IN MILD-TO MODERATE CHF Felodipine Isradipine Amlodipine SAFE WITH DItiazem Nifedipine Felodipine Isradipine Amlodipine Nicardipine B-BLOCKERS KEY: Drug Drug Approved indication Use with caution
C. Antihypertensive Drugs Hemodynamic Effects of Long-Term Administration of Antihypertensive Agents HEART CARDIAC TOTAL PERIPHERAL PLASMA PLASMA RENIN RATE OUTPUT RESISTANCE VOLUME ACTIVITY Diuretics Sympatholytic agents Centrally acting Adrenergic neuron blockers a-Adrenergic antagonists B-Adrenergic antagonists No iSat ISA Arteriolar vasodilators ↓← Ca T-channel blockers ACE inhibitors ATRA tISA, intrinsic sympathomimetic activity. ACE, angiotensin converting enzyme. ATRA, angiotensin Il-receplor antagonist.unchanged " Changes are indicated as follows: t, increased; 4, decreased;-t, increased or no change;-+, decreased or no change;
C. Antihypertensive Drugs
C. Antihypertensive Drugs Renin-angiotensin system inhibitors ACEIS: captopril卡托普利 enalapril依那普利 AT1 receptor antagonists: losartan氯沙 Renin inhibitors: enalkiren依那吉仓
Renin-angiotensin system inhibitors ACEIs: captopril 卡托普利, enalapril 依那普利 AT1 receptor antagonists：losartan 氯沙坦 Renin inhibitors: enalkiren 依那吉仑 C. Antihypertensive Drugs
Angiotensinogen Renin Angiotensin I(decapeptide) Angiotensin converting enzyme Angiotensin I( octapeptide) Angiotensinase A Adrenal cortex Angiotension lll (heptapeptide) Aldosterone Renin-Angiotensin-Aldosterone system (RAAS
Angiotensin converting enzyme Angiotensinogen Angiotensin I (decapeptide) Angiotensin II ( octapepetide) Angiotension III (heptapeptide) Renin-Angiotensin-Aldosterone system (RAAS) Renin Angiotensinase A Adrenal cortex Aldosterone
23456789「101121314 AngiotensInogen NH2-Asp-Arg-Val-Tyr-lle-His-Pro-Phe- His-Leu vallle-His-Ser-R (Renin AnglotensIn I NH2-Asp Arg-Val-Tyr-lle-His-ProlPhe His Leu-COQH aAP画 .[des-Asp]Anglotensin NH2-Arg-Val-Tyr-lle- His-Pro-PheaHis-Leu-COOH mACE■画a Angiotensin ll NH2-Aspr Arg-Val-Tyr-lle-His-ProuPhe-COOH (AP 1■■■■■■■■ AngiotensinⅢ NH2-Arg-Val-Tyr-lle-His-Pro-Phe- COOH ■■■■国■画■■国■■■画画■ angiotensin(1-7) Asp-Arg-Val-Tyr-lle-His-Pro-COOH AP)Aminopeptidase Endopeptidases Angiotensin (24.15;241;2426) Converting Enzyme Prolylcarboxypeptidase