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Drugs Mode of action Side effectsHypertension
Angiotensin converting Inhibits the conversion of Side effects:
enzyme inhibitor (ACEi) angiotensin I-> II (which prevent - Hypotonia
- Captopril the vasoconstriction) - Coughing
- Enalapril - Hyperkalemia
- (pril) - Acute kidney failure
- Angioneurotic oedema
- Fetoxicity
Contraindications:
- Bilateral renal artery
stenosis
- Primary
hyperaldosteronism
- Angio-oedema
- Pregnancy
Interactions: K+diuretics,
digoxin, lithium, NSAID
Angiotensin receptor blocker Blocks AT1 receptors in brain, Similar ACEi (except of cough)
(ARB) -sartan family: vessels and adrenal gland.
Candesartan
Ibersartan Vasodilation, reduced
Olmesartan aldosterone and ADH
(vasopressin) secretion, reduced
cardiac hypertrophy
Calcium antagonist (increased Relaxation of smooth muscle of Contraindications:
resistance all) arteries and coronary vessels - Hypotonia
- Heart failure (mainly
Dihydropyridine: nifedipine, Reduction of blood pressure, verapamil, diltiazem)
nitrendipine, felodipine and reduction of afterload, - Unstable angina pectoris
amlodipine spasmolytic effects on coronary (relative)
vessels.
Phenylalkylamine: verapamil
and gallopamil (also Inhibition of L-type Ca2+
increased CO) channels binding to a1 subunit
Benzothiazepine: diltiazem
(increased cardiac output)
Nifedipine -Rapid relaxation of vascular SE: do effect baroreceptor
smooth arterial muscle cells reflex (blood pressure drop->
(starting at arterioles) increase BP)
- Blood pressure/afterload
decrease All calcium antagonist
- Cardiac wall tension/O2 - Hypotonia
consumption - Heart failure (mainly
-Dilation of coronary vessels verapamil, diltiazem)
-Barely any direct effects on the - Unstable angina pectoris
myocardium (relative)
Mode of action:
Inhibition of cardiac> vascular L-
type calcium channels
,Verapamil Inhibition of cardiac> vascular L- Increase Frequency heart and
type calcium channels AV conduction due to
- Inhibition of SA node baroreceptor
- AV conduction decrease
- Inhibition of late Na - Arterial hypertonicity
potentials - Coronary sclerosis-
- Myocardial contractility dependent angina
decrease - Vasospastic angina
(diltiazem)
- Supraventricular
tachyarrhythmia
SE: bradycardia, AV blockade,
negative inotropic effects (HF)
- Hypotonia
- Heart failure (mainly
verapamil, diltiazem)
- Unstable angina pectoris
(relative)
- II and III AV block
- Sick sinus syndrome
- Bradycardia - -Receptor
blockade (mainly verapamil)
- Increased digoxin levels
(verapamil)
Indications:
- Arterial hypertonicity
- Vasospastic angina
(Prinzmetal‘s)
- Chronic stable angina
(amlodipine)
- Hypertensive
emergency (nifedipine)
- Raynaud‘s syndrome
Diltiazem - Inhibition of cardiac and - Arterial hypertonicity
vascular calcium - Coronary sclerosis-
channels dependent angina
- Cardiac/vascular organ - Vasospastic angina
selectivity in between (diltiazem)
compounds of the PAA - Supraventricular
and DHP types tachyarrhythmia
SE: bradycardia, AV blockade,
negative inotropic effects (HF)
- Hypotonia
- Heart failure (mainly
verapamil, diltiazem)
- Unstable angina pectoris
(relative)
- II and III AV block
- Sick sinus syndrome
- Bradycardia - -Receptor
blockade (mainly verapamil)
- Increased digoxin levels
, (verapamil)
B-blockers (metoprolol) Blocks beta receptor Cardiac:
- Bradycardias / disorders of
AV conductivity
- Worsening of heart failure
symptoms
Non-cardiac:
- Vasoconstriction / cold
feeling in the extremities
- Ischaemias
- Bronchoconstriction
- Worsening of prediabetic /
diabetic metabolism
- Obscuring hypoglycaemia
- Fatigue
- Sleep disorders…
Spironolactone (aldosterone
antagonist)
Pulmonary hypertension
Endothelin receptor
antagonists:
Bosartan, Ambrisentan and
Macitentan
Guanylate stimulators:
Riociguat
PDE5 inhibitors:
Sildenafil and Tadalafil
Prostacycline analogues:
Epoprostenol, Iloprost
andTreprotsinil
Prostacycline IP receptor
agonists: selexipa
Iloprost Stable pGI2 analogue
Alprostadil PGE1
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