Classification of Antihypertensive Drugs by Their Primary Site or Mechanism of Action Diuretics( Chapter 29) 1. Thiazides and related agents(hydrochlorothiazide, chlorthalidone, etc 2. Loop diuretics(furosemide, bumetanide, torsemide, ethacrynic id 3. K--sparing diuretics(amiloride, triamterene, spironolactone) Sympatholytic Drugs( Chapters 9, 10, 34) Noradrenergic 1. Centrally acting agents(methyldopa, clonidine, guanabenz, nerve ending guanfacine) 2. Adrenergic neuron blocking agents(guanadrel, reserpine blockers 3. B-Adrenergic antagonists(propranolol, metoprolol, etc. 4. a-Adrenergic antagonists(prazosin, terazosin, doxazosin phenoxybenzamine, phentolamine) 5. Mixed adrenergic antagonists (labetalol, carvedilol) RAas inhibitors Vasodilators(Chapter 34) 1. Arterial(hydralazine, minoxidil, diazoxide, fenoldopam 1. ACEIs 2. Arterial and venous(nitroprusside, Ca2+ Channel Blockers k Chapters 32, 34, 35)(verapamil,diltiazem 2. AT blockers nifedipine, nimodipine, felodipine, nicardipine, isradipine, amlodipine) 3. Renin inhibitors Angiotensin Converting Enzyme Inhibitors( Chapters 31, 32( captopril, enalapril, lisinopril, quinapril, ramipril, benazepril, fosinopril moexipril, perindopril, trandolapril) Angiotensin II-Receptor Antagonists(Chapters 31, 34)(losartan, candesartan, irbesartan, valsartan, telmisartan, eprosartan)
Commonly used antihypertensive drugs (1)Diuretics: Hydrochlorothiazide (2) Calcium antagonists Nifedipine, amlodipine, verapamil, etc. (3)Angiotensin II receptor antagonists: Lasartan, etc (4) Angiotensin-converting enzyme inhibitors Captopril, enalapril, etc. (5)B-Blockers: Propranolol, etc. (6)ar-Blockers: Prazosin, doxazosin, etc. (7)Central sympatholytics: Clonidine, etc. (8)Potassium channel openers: Minoxidil, diazoxide, etc. (9)Vasodilators: Sodium nitroprusside, etc
C. Antihypertensive Drugs Diuretics 1. Pharmacological effects (1) Reducing plasma volume (cardiac output (2)Reducing Nat and Nat-Ca2t exchange in vascular smooth muscle cells(Ca2+; 4, peripheral resistance l)
Proximal NaHCO3 Nacl Ca2+ Distal convoluted involuted Thiazides (+PTH) tubule K+ sparing H Ca2 Collecting Glomerulus H2o di suretIes tubule Cortex +aldosterone 00p Diuretics diuretics Acetazolamide ascending limb Osmotic agents(mannitol H2O Loop agents(eg, furosemide) Thin (+ADH) descending Collecting 4)Thiazides limb duct 5)Aldosterone antagonists Thin ADH antagonists ascending Henle Inner medulla Main diuretics
类别 (主要作用部位) 其他分类名 作用机制 利尿应用 非利尿应用 碳酸酐酶抑制药 抑制碳酸酐酶利尿药耐受的病青光眼,高山病 (近曲小管) 人,与袢利尿药合代谢性碱中毒 用 渗透性利尿药脱水药 增高尿液渗透压急性肾功能衰竭脑水肿,青光眼 (髓袢及其他部 位) 袢利尿药(髓袢1.高效能利尿药抑制NaK+2C1各种严重水肿,高钙血症,加速 升支粗段) 2.NaK+2C1同同向转运 急性肾功能衰竭毒物排出 向转运体抑制药 噻嗪类利尿药1.中效能利尿药抑制Na-CI同向各种水肿 高血压,高尿钙 (远曲小管)2NaC1同向转转运 症,尿崩症 运体抑制药 保钾利尿药(集低效能利尿药1拮抗醛固酮作水肿(尤其对伴失钾和域失镁 合管、末段远曲 用(螺内酯)有醛固酮增高者, 小管) 2.抑制上皮细胞如肝硬化病人) Na通道(氨苯蝶 啶,阿米洛利)