ACE inhibitor
Stops the conversion of angiotensin I to II.
Angiotensin II is a vasoconstrictor and stimulates aldosterone secretion
Rampril/ Captopril
Start at 1.25mg(HF)/2.5mg titrate up to 10mg
S/E: Cough/ Postural hypotension
Must check renal function after 2/52 weeks due to the nephrotoxic effects
Calcium channel blockers
Decrease Ca2+ entry into the vascular and cardiac cells. Calcium stimulates contraction.
Results in relaxation and vasodilation in the arterial smooth muscle
•Dihydropyridine: vasodilates
•Non dihydropyridine: Cardiac contractibility and conduction of the heart
Amlodipine
HTN: 5-10mg daily
S/E: Worsening HF, Flushing, oedema, gum hypertrophy
Thiazide diuretic
Inhibits the Na/CL co transporter in the DCT of the nephron.
Bendroflumethiazide/ Indapamide 2.5mg S/E: Impotency Contraindication in gout Decrease in sodium and potassium
Alpha blocker
Blocks the alpha one adrenoreceptor
Vasodilatation
Doxazosin (Note that Tamsulosin is only licensed for BPH)
1mg daily
S/E: Anxiety, back pain and coughing
Angiotensin II blocker
Block the action of angiotensin II on the AT1 receptor
Losartan / Cadasartan
12.5mg= HF
50mg other conditions
S/E: Vertigo, symptomatic hypertension
Aldosterone antagonist
Aldosterone is a mineralocorticoid blocker on the mineralocorticoid receptor in the DCT of the kidneys decreasing the activity of the EnaC. Reduces the reabsorption of sodium and water.
Spironolactone
25mg for heart failure/ resitant hypertension
S/E: Gyanecomastia, Anxiety, Hypotenison, Hyperkalaemia ( tall tented T waves)
Digoxin
Negatively chronotropic (reduces HR) and positively inotropic (increases force of contraction) Inhibitions of the Na+/K+ atpase pumps causing Na+ to accumulate in the cells. As a result, Ca also accumulates in the cells resulting in a higher contractile force.
Digoxin 125-250mg (maintenance dose)
B blockers
Act on the B 1 receptors
Relax the heart
Blocks sympathetic nervous system
Best one for heart failure is Bisproprolol (1.25mg to 10mg)
Atenolol
S/E: Bronchospasm, alopecia,