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Dept of pharmacy
Jagannath University
HYPERTENSION is defined as either a sustained
systolic blood pressure (SBP) of greater than 140 mm
Hg or a sustained diastolic blood pressure (DBP) of
greater than 90 mm Hg.
Hypertension results from increased peripheral
vascular smooth muscle tone, which leads to
increased arteriolar resistance and reduced
capacitance of the venous system.
1.ACE (Angiotensin Converting
Enzyme)inhibitor:
Captopril,Enalapril, Ramipril etc.
5.Diuretics :
Arteriolar : Hydralazine,Minoxidil.
Arteriolar & Venous : Sodium nitroprusside.
Bronchoconstriction
CO>increase BP
Aldosterone also causes water to be
reabsorbed along with sodium; this increases
blood volume and therefore blood pressure.
Thus, aldosterone indirectly
regulatesblood levels of electrolytes (sodium,
potassium and hydrogen) and helps to maintain
the blood pH.
ADVERSE EFFECT :
Dry cough, rash, fever, altered taste, hypotension (in
hypovolemic states), and hyperkalemia, fatigue, angioedema,
headache, dizziness.
Mechanism of action:
Enalaprilat competes with angiotensin I for binding at the
angiotensin-converting enzyme, blocking the conversion of
angiotensin I to angiotensin II.
Mechanism of action:
• Ramiprilatcompetes with
angiotensin I for binding at the
angiotensin-converting enzyme.
blocking the conversion of
angiotensin I to angiotensin II.
As angiotensin II is a vasoconstrictor
and a negative-feedback mediator for
renin activity Lower concentrations
result in a decrease in blood pressure
and an increase in plasma renin.
• Ramiprilat may also act on kininase II,
an enzyme identical to ACE that
degrades the vasodilator bradykinin.
Pharmacokinetic data:
Bioavailability : 28%, Protein binding :73%
(ramipril)
56% (ramiprilat), Metabolism : Hepatic, to
ramiprilat Half-life : 2 to 4 hours, Excretion :
Renal (60%) and fecal (40%).
Contrindication :