Drug Classes: Other Antihypertensives

Contains information about:

• Centrally-Acting Anti-Adrenergics
• Vasodilators
• Renin Inhibitors
• Peripherally-Acting Anti-Adrenergics

Centrally-Acting Anti-Adrenergics

Use: Mild to moderate hypertension
Mechanism of Action: Stimulates alpha adrenergic receptors to decrease adrenergic response and decrease blood pressure
Contraindications: Geriatric patients with an increased fall risk
Pregnancy Category:

• (Methyldopa) B - Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women OR Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester.
• (Clonidine, Guanfacine) C - Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Availability:

• Catapres - Clonidine
  
  • Tablets: 0.1mg, 0.2mg, 0.3mg
  • Transdermal Patch: 0.1mg/24hrs, 0.2mg/24hrs, 0.3mg/24hrs
• Tenex, Intuniv* - Guanfacine
  
  • Tablets: 1mg, 2mg
  • Extended Release Tablets* (indicated for ADHD only): 1mg, 2mg, 3mg, 4mg
• Aldomet - Methyldopa
  
  • Tablets: 125mg, 250mg, 500mg
  • Suspension: 250mg/5ml

Common Side Effects:

• Drowsiness
• Dry Mouth
• Withdrawal phenomenon (clonidine only)
• Sedation
• Erectile dysfunction

Combination Drugs:

• Clorpres - Clonidine/ Chlorthalidone (Diuretic)
• Aldoril - Methyldopa/ Hydrochlorthiazide (Diuretic)
• Aldoclor - Methyldopa/ Chlorthalidone (Diuretic)

Miscellaneous:

• Clonidine, Guanfacine - sometimes used to treat certain psyciatric condtions
• Methyldopa - approved to treat hypertension during pregnancy

Vasodilators

Use: Moderate to severe hypertension
Mechanism of Action: Dilates peripheral arterioles
Contraindications: Tartazine intolerance
Pregnancy Category: C - Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
Availability:

• Apresoline - hydrALAZINE
  
  • Tablets: 10mg, 25mg, 50mg, 100mg
    

Common Side Effects:

• Tachycardia
• Sodium Retention
• Drug-Induced Lupus Syndrome

Combination Drugs:

• BiDil - hydrALAZINE/ Isosorbide Dinitate (Nitrate)

Miscellaneous:

• Do not confuse with hydroxyzine

Renin Inhibitors

Use: Hypertension
Mechanism of Action: Inhbits renin, causing a decrease in production of angiotensin II
Contraindications: Known or suspected pregnancy, coadministration with high-fat meals
Pregnancy Category: C - Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
Availability:

• Tekturna - Aliskirin
  
  • Tablets: 150mg, 300mg

Common Side Effects:

• Diarrhea (especially in females and elderly patients)

Combination Drugs:

• Tekturna HCT - Aliskiren/ Hydrocholothiazide (Diuretic)

Miscellaneous:

• One of the newest class of anti-hypertensives on the market

Peripherally Acting Anti-Adrenergics (alpha blockers)

Use: Hypertension, Benign Prostatic Hyperplasia (BPH - this indication to be discussed later)
Mechanism of Action: Blocks post-synaptic alpha1-adrenergic receptors, causing aterial and venous dilation
Contraindications: Hypersensitivity, volume depletion
Pregnancy Category: C - Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
Availability:

• Cardura - Doxazosin
  
  • Tablets: 1mg, 2mg, 4mg, 8mg
• MiniPres - Prazosin
  
  • Capsules: 1mg, 2mg, 5mg
• Hytrin - Terazosin
  
  • Capsules: 1mg, 2mg, 5mg, 10mg

Common Side Effects:

• Dizziness
• Headache
• First-dose orthostatic hypotension
• Weakness
• Palpitations
• Nausea
• Congestion

Combination Drugs: None
Miscellaneous:

• Usually end in -azosin