Question

compare and contrast five antihypertensive treatments.

Answer 1

ANTIHYPERTENSIVE TREATMENT MAINLY INCLUDES : NUTRITIONAL THERAPY,DRUG THERAPY AND LIFESTYLE MODIFICATION.

Lifestyle modification include weight reduction ,moderation of alcohol consumption ,physical activity ,avoidance of tobacco product and stress management.

Nutritional therapy include DASH eating plan and dietary sodium reduction.

Dash eating plans involves eating several servings of fish each week, eating plenty of fruits and vegetables, increasing fibre intake, and drinking a lot of water. That dash diet significantly lower BP.

DRUG THERAPY FOR HYPERTENSION/ ANTIHYPERTENSIVE DRUGS:

DRUGS	MECHANISM OF ACTION	SIDE EFFECT
DIURETICS (Eg: Thiazide)	Inhibit NaCl reabsorption in the distal convoluted tubule; increase excretion of Na+ and Cl-.Initial decrease in ECF.;sustained decrease in SVR.Lower BP moderately in 2-4 weeks.	Fluid and electrolyte imbalances; CNS effect- headache and weakness,vertigo; gastrointestinal effect-anorexia,nausea, vomiting, diarrhoea, constipation; Sexual problems - erectile dysfunction, decreased libido; blood dyscrasias ; and Dermatologic effects
Adrenergic inhibitors (Eg:Clonidine)	Reduces sympathetic outflow from CNS. Reduces peripheral sympathetic tone, produces vasodilation, decreases SVR and BP.	Dry mouth, sedation, erectile dysfunction, nausea , dizziness, sleep disturbance, depression. Symptomatic bradycardia in patients with conduction  disorder.
Direct vasodilators (Eg:Fenoldopam)	Activates dopamine receptors,resulting in systemic and renal vasodilation.	Tachycardia,Angina, headache, nausea, flushing
Ganglionic blockers (Eg:trimethaphan)	Interrupts adrenergic control of arteries ,result in vasodilation, and reduces SVR and BP.	Visual disturbance, dilated pupils, dry mouth, urinary hesitancy, subjective chillness.
Calcium channel blockers (Eg: Amlodipine, Felodipine,isradipine)	Block movement of extracellular calcium in to cells, causing vasodilation and decreased heart rate, contractility and SVR.	Bradycardia, first degree AV block, nausea ,headache, peripheral edema, flushing ,gingival hyperplasia,Rashes,constipation