Blood Pressure Medicines Information

 

The term "hypertension" literally means an abnormally raised arterial blood pressure. There are many conditions which elevate arterial pressure, including primary kidney disease, pheochromocytoma, hyperthyroidism, hyperaldosteronism and coarctation of aorta, leading to secondary hypertension. In about 80 to 85 per cent of patients of hypertension, no specific cause is evident, and such a condition is labeled as primary or essential hypertension.

Antihypertensive Drugs

Most antihypertensive drugs can effectively reduce mildly elevated blood pressure, but their use is associated with many side effects. Thus the decision whether to use a drug to control borderline or mild hypertension is made on the basis of the benefit: risk ratio.

High Blood Pressure Drug List

Brand Name Generic Name Type
Atacand candesartan  ACE Inhibitors
Adalat nifedipine  Calcium Channel Blocker
Aldoclor methyldopa / chlorothiazide Alpha-II  Agonists / Centrally Acting Drugs
Aldomet methyldopa  Alpha-II  Agonists / Centrally Acting Drugs
Aldoril methyldopa / HCT Alpha-II  Agonists / Centrally Acting Drugs
Atacand HCT candesartan + HCT  ACE Inhibitors
Avalide irbesartan + HCT  ACE Inhibitors
Avapro  irbesartan  ACE Inhibitors
Azor amlodipine / olmesartan  Calcium Channel Blocker
Benicar  olmesartan ACE Inhibitors
Benicar HCT  olmesartan + HCT  ACE Inhibitors
BiDil hydralazine / isosorbide dinitrate Direct Vasolidator
Brevibloc esmolol Beta Blocker
Bystolic nebivolol Beta Blocker
Calan  verapamil  Calcium Channel Blocker
Cardene nicardipine  Calcium Channel Blocker
Cardizem diltiazem  Calcium Channel Blocker
Cardura doxazosin  Alpha-I Adrenergic Blockers Agent
Cartrol carteolol  Beta Blocker
Catapres clonidine  Alpha-II  Agonists / Centrally Acting Drugs
Cleviprex clevidipine  Calcium Channel Blocker
Clorpres clonidine / clorthalidone  Alpha-II  Agonists / Centrally Acting Drugs
Combipres clonidine / clorthalidone  Alpha-II  Agonists / Centrally Acting Drugs
Coreg  carvedilol Beta Blocker
Corgard nadolol Beta Blocker
Corzide nadolol / bendroflumethiazide Beta Blocker
Covera verapamil  Calcium Channel Blocker
Cozaar losartan ACE Inhibitors
Dibenzyline  phenoxybenzamine Alpha-I Adrenergic Blockers Agent
Dilacor diltiazem  Calcium Channel Blocker
Diltia diltiazem  Calcium Channel Blocker
Diovan valsartan  ACE Inhibitors
Diovan HCT valsartan + HCT  ACE Inhibitors
Duraclon  clonidine Alpha-II  Agonists / Centrally Acting Drugs
DynaCirc  isradipine  Calcium Channel Blocker
Esimil guanethidine + HCT  Alpha-I Adrenergic Blockers Agent
Exforge amlodipine / valsartan  Calcium Channel Blocker
Exforge valsartan + amlodipine  ACE Inhibitors
hydralazine hydralazine  Direct Vasolidator
Hylorel guanadrel  Alpha-I Adrenergic Blockers Agent
Hyperstat diazoxide  Direct Vasolidator
Hytrin terazosin  Alpha-I Adrenergic Blockers Agent
Hyzaar losartan + HCT  ACE Inhibitors
Imdur, Ismo isosorbide mononitrate Direct Vasolidator
Inderal propanolol   Beta Blocker
Inderide propanolol + HCT  Beta Blocker
Inno-PranXL propanolol  Beta Blocker
Ismelin guanethidine  Alpha-I Adrenergic Blockers Agent
Isoptin  verapamil  Calcium Channel Blocker
Isordil isosorbide dinitrate  Direct Vasolidator
Kerlone betaxolol   Beta Blocker
Levatol penbutolol  Beta Blocker
Lexxel felodipine / enalapril  Calcium Channel Blocker
locadren  timolol  Beta Blocker
Lonitrin minoxidil  Direct Vasolidator
Lopressor metoprolol   Beta Blocker
LopressorHCT metoprolol + HCT  Beta Blocker
Lotrel amlodipine / benazepril  Calcium Channel Blocker
Micardis HCT telmisartan + HCT  ACE Inhibitors
Micardis telmisartan  ACE Inhibitors
Minipress prazosin  Alpha-I Adrenergic Blockers Agent
Minizide prazosin + polythiazide Alpha-I Adrenergic Blockers Agent
Nimotop nimodipine  Calcium Channel Blocker
Nitro-Bid nitroglycerin  Direct Vasolidator
nitroprusside sodium nitroprusside  Direct Vasolidator
Normodyne labetalol  Beta Blocker
Norvasc amlodipine  Calcium Channel Blocker
Plendil felodipine  Calcium Channel Blocker
Procardia nifedipine  Calcium Channel Blocker
Regitine phentolamine Alpha-I Adrenergic Blockers Agent
Rogaine (FDA approved for hair loss) minoxidil  Direct Vasolidator
Sectral acebutolol  Beta Blocker
Sorbitrate isosorbide dinitrate Direct Vasolidator
Sular nisoldipine  Calcium Channel Blocker
Tarka verapamil/trandolapril  Calcium Channel Blocker
Teczem diltiazem/enalapril  Calcium Channel Blocker
Tenex guanfacine Alpha-II  Agonists / Centrally Acting Drugs
Tenoretic atenolol / chlorthalidone  Beta Blocker
Tenormin atenolol Beta Blocker
Teveten eprosartan ACE Inhibitors
Teveten HCT eprosartan + HCT ACE Inhibitors
Tiamate  diltiazem Calcium Channel Blocker
Tiazac diltiazem Calcium Channel Blocker
Timolide timolol + HCT   Beta Blocker
Toprol metoprolol   Beta Blocker
Trandate labetalol Beta Blocker
Vasocor bepridil Calcium Channel Blocker
Verelen verapamil Calcium Channel Blocker
Visken pindolol Beta Blocker
Zebeta bisoprolol Beta Blocker
Ziac bisoprolol / HCT Beta Blocker

 

Antihypertensive Drugs Classification

Drugs influence arterial blood pressure at four effector sites- arterioles (resistance vessels); veins (capacitance vessels); heart; and the kidneys—by several different mechanisms. They can be classified according to their site or mode of action as follows:

I. Diuretics

(i) Thiazides and related agents (hydrochlorothiazide, chlorthalidone etc.)
(ii) High ceiling loop diuretic (frusemide, bumetanide, ethacrynic acid)
(iii) Potassium sparing diuretics (spironolactone, triamterene, amiloride)
(iv) Osmotic diuretics
(v) Calcium-sparing diuretics
(vi) Low ceiling diuretics

Read Diuretic Drugs for more information.

II Sympatholytic Drugs

(i) Centrally acting agents (methyldopa, clonidine).
(ii) Ganglion blocking agents (trimethaphan).
(iii) Adrenergic neuron blocking agents (guanethidine, guanadrel, reserpine).
(iv) Beta-adrenoceptor blockers ( metoprolol, atenolol etc.)
(v) Alpha-adrenoceptor blockers (prazosin, terazosin, doxazosin, phenoxybenzamine).
(vi) Alpha+beta blockers (labetalol, carvediol).

III. Vasodilators

(i) Arterial (hydralazine, minoxidil, diazoxide)
(ii) Arterial and venous (nitroprusside)

IV. Calcium Channel Blockers
Verapamil, nifedipine, nicardipine, nitrendipine.
. Angiotensin Converting Enzyme Inhibitors 
Captopril, enalparil.

VI. Angiotensin II Receptor Blockers
Losartan, valsartan

VII. Potassium Channel Opener
Pinacidil

Diuretics Antihypertensive Drugs

Diuretics are still used as initial drugs of choice for mild hypertension in the majority of cases. They can be used alone, or in combination with other classes of antihypertensive drugs.

Methyldopa 
Methyldopa (alpha-methyldopa) is recommended for the treatment of most types of hypertension. Its potency lies between that of guanethidine and reserpine. Methyldopa is a structural analogue of dihydroxyphenylalamine and differs from it only by the presence of a methyl group on the a-carbon of the side chain.

Trimethaphan
Trimethaphan is a short-acting ganglion blocking agent. The blocking action is exerted at the postsynaptic cholinergic receptor in autonomic ganglia. This competitive antagonism is short-lived.

Guanethidine 
Guanethidine is a potent drug for the relief of severe hypertension, and has relatively lower incidence of side effects.

Propranolol
After propranolol many beta-blockers have been introduced. All beta-blockers share the common property of being competitive inhibitors of catecholamines.

Antihypertensinve Alpha-Adrenoceptor Blockers

Prazosin
Prazosin acts by a competitive postsynaptic alphs1-adrenoceptor blockade. It does not block the presynaptic inhibitory effects, which allow reflex action to overcome the postural hypotension usual with alpha-blockade.

Doxazosin 
Doxazosin is a water-soluble quinazoline analogue to prazosin with selective alpha1-adrenoceptor inhibiting action. It has no direct action on the vascular smooth muscle.

Terazosin
Terazosin is a long-acting selective alpha1-adrenoceptor blocker. It reduces TPR, and has little effect on the heart rate, Terazosin may be used alone or with a diuretic in patients with mild to moderate hypertension.

Phenoxybenzamine 
Phenoxybenzamine is an orally effective, long-acting non-selective (alpha and alpha) alpha-adrenoceptor blocking agent.

Labetalol 
Labetalol has an alpha blocking action, with a non-specific beta and beta-adrenoceptor blocking action. On oral administration the ratio of alpha to beta blockade is about 1:3.

Hydralazine 
Hydralazine (1-hydrazinopthalazine hydrochloride) is a potent direct relaxant of vascular smooth muscle, but often produces considerable reflex cardiac stimulation. This drug reduces both systolic and diastolic BP.

Minoxidil 
Minoxidil dilates arteriolar resistance vessels with minimal effects on venous capacitance vessels. It reduces calcium uptake through the cell membrane, thereby reducing arteriolar tone and lowering peripheral vascular resistance.

Diazoxide 
It is a non-diuretic thiazide. On prolonged use it leads to diabetes mellitus, although no permanent in nature. Hence, it is not used as a routine hypotensive.

Sodium Nitroprusside 
Sodium nitroprusside is a short-term hypotensive agent. It reduces TPR by a direct action on blood vessels and may be used in the treatment of hypertensive crisis.

Antihypertensive Calcium Channel Blockers

Verapamil 
Verapamil is a calcium blocker used in the chronic management of angina pectoris; and in the control of supraventricular arrhythmias. Verapamil is also useful in the control of mild to moderate hypertension.
Angiotensin converting enzyme inhibitors are orally effective antihypertensive, used either alone or in combination with other antihypertensive agents for treating mild to moderate hypertension. Captopril in higher doses can be used for controlling severe and resistant forms of hypertension. Enalparil is a prodrug, converted by de-esterification to a converting enzyme inhibitor.

Antihypertensive Angiotensin II Receptor Blockers

The older agent, saralasin is an Angiotensin II analogue, and a competitive inhibitor of Angiotensin II at both its receptors (AT1 and AT2 sites). It blocks the pressor and aldosterone releasing effects of Angiotensin II, and lowers BP in high rennin states like renal artery stenosis and ischemia.

Losartan 
Losartan is a recently introduced blocker of the AT1 receptor. It has no effect on bradykinin metabolism, and therefore a moiré selective blocker of Angiotensin effects than the ACE inhibitors.

Antihypertensive Potassium Channel Opener

Pinacidil
Pinacidil is a potent vasodilator, and is the first antihypertensive drug classified as a potassium channel opener, although it is likely that minoxidil and diazoxide also lower BP by this mechanism.


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