Medication for Hypertension

Medication are used to control the blood pressure which prescribed by your doctor.

Note: Generic name is the common name of the drug. For example, Panadol is the brand name while its generic name is paracetamol.

Basically, there are 8 classes of drugs.

Alpha Blocker

Have vasodilating effect means will cause the widening of the blood vessels. This will eventually reduce the arteries’ (one of the 3 main blood vessel in our body) resistance, and cause rapid reduction in blood pressure.

Side effect:

·       Nausea
·         Urinary frequency
·         Tachycardia ( rapid or accelerated heartbeat)
·         Dizziness
·         Headache
·         Palpitations ( the feeling of abnormality in the normal beating of heart)
·         Postural hypotension ( Drop in blood pressure due to a change in body position)

Avoid using on children <12 years old and also person that have congestive heart failure (the heart unable to provide enough pump action)

Example of medication in their generic name: Doxazosin, Prazosin, Terasozin

Examples of Alpha Blocker Drugs in the Market

 Angiotensin-converting enzyme inhibitors (ACE Inhibitors)

These drugs will block the effects of angiotensin which will causes the arteries to become narrow especially in the kidneys but also throughout the body. This drug will help the body to produce less angiotensin since the enzyme is blocked to produce this chemical. Less angiotensin means arteries are less becoming narrows which help the blood vessels relax and open up which then lowers blood pressure.

Side Effects:

·         Dizziness
·         Headache
·         Fatigue
·         Gastrointestinal irritation and abdominal pain
·         Cough
·         Rash
·         Flushing
·         Nausea
·         Diarrhea
·         Hypotension
·         Tachycardia (rapid heartbeat)

Avoid using on person who having edema, women that pregnant and breastfeeding, hypersensitivity (allergy) and children are not recommended to this drug.

Example of Drugs in generic name: Captopril, Ramipril, Enalapril, Lisinopril, Fosinopril.

Angiotension Receptor Blockers (ARB)

The narrowing effect of angiotensin will be blocked by this drug. This is because angiotensin needs a receptor-like to bind with in order to constrict the blood vessel. ARB blocks the receptors, no binding of angiotensin with the receptors mean no constriction of blood vessel. Blood vessels remained open and blood pressure is reduced.

Side effects:

·         Flushing
·         Headache
·         Back pain
·         Dizziness
·         Anxiety
·         Gastrointestinal disturbances (feeling discomfort on your digestive system)
·         Fatigue

Avoid using on person that having kidney and liver problem, pregnant and breastfeeding mother also avoid from using this drug.

Example of drugs in its generic name: Losartan, Valsartan, Candesartan, Telmisartan

An Example of ARB drugs product in the market

Beta blockers

This drug will reduce the heart rate, heart’s workload and the output of blood which then lowers the blood pressure.

Side effect:

·         Dizziness
·         Nausea
·         Fatigue
·         Diarrhea
·         Gastrointestinal and sleep disturbances
·         Hallucinations
·         Lethargy
·         Cold extremities (feeling of cold at the hand and leg)
·         Cramps and muscle weakness
·         Hypotension (low blood pressure)

Avoid using for person that have metabolic acidosis (a condition where body produce too much acid or the kidney failed to remove the excess acid from our body) , obstructive airway disease, broncospasm, woman that pregnant and breastfeeding.

Note: Dosage reduction is needed in kidney failure patient as it is excreted by the kidney.

Examples of drugs in its generic name: Metoprolol, Propanolol, Acebutolol, Atenolol, Bisoprolol, Sotalol.

Calcium Channel Blockers

This medicine will prevents calcium from entering the smooth muscle cells of the heart and arteries. This is because the entering of calcium will causes a stronger and harder contraction, so the blocking the entering of calcium into the muscle cells will cause the hearts’ contraction is not as forceful. Calcium channel blockers relax and open up narrowed blood vessels, reduce heart rate and lower blood pressure.

Side effect:

·         Dizziness
·         Fatigue
·         Headache
·         Bradycardia (slow heart rate)
·         Nausea
·         Gastrointestinal disturbances
·         Constipation
·         Skin flushing

People who have low blood pressure associated with heart damaged that it is unable to supply enough blood to the organs of the body cannot take this drug. Allergy patient and pregnant woman also cannot take this drug same goes to breastfeeding mother.

There are 3 types of calcium channel blockers, they having the same function, only that the mechanism of action are different:

1.      Dihydropiridine
a.       Amlodipine
b.      Felodipine
c.       Nicardipine
d.      Nifedipine
e.       Lacidipine

2.      Verapamil
3.      Diltiazem

Centrally Acting Drugs

Or sometime you may find it as Peripheral Adrenergic Inhibitors in the internet. This drug is now rarely used unless other medications couldn’t help and in pregnancy. This drug will reduce the blood pressure by blocking the neurotransmitters in the brain where the smooth muscles will not get “message” to constrict. No constriction of blood vessels, blood pressure reduced.

Side effect:
·         Depression
·         Dry mouth
·         Sedation
·         Fluid retention
·         Rashes
·         Nausea

Patients that have depression and kidney or liver problem should not take this drug. Active hepatitis patient also should omit from taking this drug.

Examples of drugs: Methyldopa, Reserpine, Clonidine

Direct Vasodilators

Nowadays, this class of drugs mostly used in hypertensive crisis only. Direct vasodilators will cause the muscle in the walls of the blood vessels to relax and allowing it to dilate. This will allows blood to flow through better.

Side effect:

·         Tachycardia
·         Fluid retention
·         Nausea
·         Vomiting
·         Headache
·         Abdominal pain
·         Palpitations

Patient with severe tachycardia, severe liver impairment should not prescribe with this drug.

Examples of drug: Hydralazine, sodium nitroprusside, nitroglycerin. Minoxidil should be reserved for treatment of severe hypertension resistant to other drugs.

Product that available in market

Diuretics

This drug helps the body to get rid of excess sodium (salt) and water and help control blood pressure. They are often used in combination with additional prescription therapies.

Side Effect:

·         Electrolyte disturbances

Exampls of drugs are divided into three groups:

1.      Loop Diuretics

a.       Bumetanide

b.      Frusemide

2.      Potassium-sparing diuretics

a.       Amiloride

b.      Triamterene

3.      Thiazides and related diuretics

a.       Chlorothiazide

b.      Hydrochlorothiazide

c.       Indapamide