Thiazide diuretics odlum water retention t:Ca2+ exchange↑, Ca2;↓ in vascular Blood smooth muscle cells volume Peripheral Cardiac resistance output Decrease in blood pressure
C. Antihypertensive Drugs 2. Clinical uses ( Hypertension single or com bined with other drugs mild to moderate hypertension particularly useful in the treatment of elderly patients pure systolic hypertension, hypertension with heart failure (2)Other uses: as diuretic agents, etc
C. Antihypertensive Drugs 3. Adverse effects plasma levels of renin T hypokalemia yperuricemla hyperglycemia yperlipidemia
C. Antihypertensive Drugs Hemodynamic Effects of Long-Term Administration of Antihypertensive Agents HEART CARDIAC TOTAL PERIPHERAL PLASMA PLASMA RENIN RATE OUTPUT RESISTANCE VOLUME ACTMVITY Diuretics Sympatholytic agents Centrally acting Adrenergic neuron blockers a-Adrenergic antagonists B-Adrenergic antagonists ↓↓↓↓↓ No isat ISA Arteriolar vasodilators Ca2t-channel blockers ↓or↑ ↓or↑ ACE inhibitors ATRA fISA, intrinsic sympathomimetic activity. ACE, angiotensin converting enzyme. ATRA, angiotensin l-receptor antagonism *> unchanged. " Changes are indicated as follows: 1, increased; I, decreased; -t, increased or no change;-+, decreased or no change
C. Antihypertensive Drugs Calcium channel blockers Nifedipine硝地平 1. Pharmacological effects Relaxing vascular smooth muscles 2. Clinical uses Mild to severe hypertension(usually combined with B receptor blockers