Drugs Mechanism of actions Clinical Applications Toxicities

DIURETICS
Blocks Na/Cl transporter in the distal Hypertension Hypokalemia
Thiazides convoluted tubule Mild edema Hyperglycemia
Hyperlipidemia
Hydrochlorothiazide Hyperuricemia
Chlorthalidone
Loop diuretics Block Na/K/2Cl transporter in thick Hypertension Hypokalemia
ascending limb Heart failure Hypovolemia
Furosemide Edema Ototoxicity
SYMPATHOPLEGICS
Alpha2 agonist that reduces SANS Hypertension Rebound HTN
Centrally acting outflow

Clonidine
Methyldopa Alpha2 agonist that reduces SANS Hypertension Hemolytic anemia
outflow
Ganglion blockers
Blocks all ANS outflow Hypertensive emergencies Severe orthostatic hypotension
Trimethaphan
Postganglion blockers Blocks vesicular pump VMAT in Hypertension Severe psychiatric depression (high
adrenergic neuron Huntington’s disease doses)
Reserpine
Guanadrel, guanethidine Blocks release of NE, depletes stores Same as reserpine Severe orthostatic hypotension

Alpha blockers Reduces vascular resistance and relaxes Mild hypertension First dose orthostatic hypotension
prostate smooth muscles BPH
Prazosin
Beta blockers Reduces cardiac output Hypertension Bradycardia
Propranolol Angina CHF
VASODILATORS
Calcium channel blockers Reduces cardiac output Hypertension Constipation
Angina
Nifedipine
Verapamil Verapamil blocks P-glycoprotein Arrhythmias Cardiodepressant effects < Nifedipine
Diltiazem transporter

Older vasodilators Releases nitric oxide from endothelial Hypertension Lupus erythematosus syndrome
cells Heart failure (with combination of Tachycardia
Hydralazine isosorbide dinitrate) Salt and water retention

Minoxidil Opens K channels—hyperpolarization- Severe Hypertension Hirsutism

relaxation of smooth muscles Treatment for baldness Tachycardia
Salt and water retention
Parenteral vasodilators Release NO from the drug Hypertensive emergencies Excessive hypotension
Thiocyanate and cyanide poisoning due
Nitroprusside to prolonged infusion
Diazoxide Opens K channels—relaxation of Hypertensive emergencies Hyperglycemia
vascular smooth muscles Hypoglycemia due to insulin secreting Excessive hypotension
tumors
Fenoldopam Dopamine 1 agonist, arteriolar Hypertensive emergencies Excessive hypotension
vasodilation
Renin inhibitor Inhibit angiotensin 1 synthesis Hypertension Angioedema
Renal impairment
Aliskiren
ANGIOTENSIN INHIBITORS Inhibits ACE, inhibits angiotensin II and Hypertension Coughing (bradykinin )
aldosterone synthesis Heart failure Hyperkalemia
ACE inhibitors Diabetic renal disease Teratogen

Captopril
Angiotensin II Receptor Blockers Inhibits the Angiotensin II into its Hypertension Hyperkalemia
Losartan receptor sites, blocks AT1 receptors Teratogen