lecture obat antihipertensi ppt

8/16/2019 lecture obat antihipertensi ppt

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DRUGS USED IN

HYPERTENSIONGM. AMANBAG. FARMAKOLOGI FK. UNUD


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INTRODUCTION

BLOOD PRESSURE DETERMINED BY:

> Blood volume

> Sym!"#e#$% #o&e > '"(%ul") (moo#! mu(%le #o&e

> A&*$o#e&($& e+e%#


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STRATEGIES FOR TREATING ,YPERTENSION

REDUCTION OF BLOOD 'OLUME

REDUCTION OF SYMP,ATETIC TONE

REDUCTION OF 'ASCULAR SMOOT, MUSCLE TONE

REDUCTION OF ANGIOTENSIN EFFECT


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REDUCTION OF BLOOD 'OLUME

Thiazide Diuretic :

> #!e mo(# $mo)#" -o) "$

!ye)#e&($ve d)u* > e(e%$"lly -o) lo&* #e)m #!e)"y

> -o) m$ld "&d mode)"#e !ye)#e&($o&

Furosemide Diuretic:

> u(ed $& (eve)e !ye)#e&($o&

> m"l$*&" !ye)#e&($o&


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REDUCTION IN SYMP,ATETIC TONE

Ce)"lly "%#$&* (ym"#!ole*$%

d)u*(G"&*l$o& lo%/$&* "*e(

Ad)e&e)*$% &eu)o& lo%/$&* d)u*(

0Postganglionic SymphateticNerve Terminal Blocker 1

Ad)e&o%e#o) lo%/$&* d)u*(


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CENTRALLY ACTING

SYMPAT,OPLEGIC DRUGSCLONIDINE

> (ele%#$ve 23 "*o&$(#

> %"& %"u(e )eou&d !ye)#e&($o&$-

"dm$&$(#)"#$o& (#o (udde&ly

> %"& %"u(e (ed"#$o&


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CENTRALLY ACTING

SYMP,ATOPLEGIC DRUGMETHLDOP!

> %o&ve)#ed #o 2 me#!yl do"m$&e

"&d 2 me#!yl&o)e$&e!)$&e

> (ele%#$ve 23 "*o&$(#

> %"& %"u(e (ed"#$o&

> %ome&("#o)y )e(o&(e ("l#)e#e$o&


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GANGLION BLOCKING AGENTS

0GABA1He"amethoni#m $ Trimetharphan

> lo%/ ")"(ym"#!e#$% &e)ve4 %"&

%"u(e A#)o$&e l$/e e+e%#

> lo%/ (ym!"#e#$% &e)ve4 %"& %"u(e

o)#!o(#"#$% !yo#e&($o& "&d (e5u"l dy(-u&%#$o&


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POSTGANGLIONIC SYMP,ATETIC

NER'E TERMINAL BLOCKER%ESE%PINE

> $&!$$# )eu#"/e 0u#"/e 6 7

u#"/e31 > dele#$o& o- NE4 Do"m$&e4

Se)o#o&$&

0e)$!e)"l "&d %e)"l1

> #o5$% e+e%# : de)e(($o&


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POSTGANGLIONIC SYMP,ATETIC

NER'E TERMINAL BLOCKERS&'!NETHIDINE

> *u"&e#!$d$&e u#"/e #o*e#!e) 8$#! NE

"&d (#o)e $& NE ve($%le 0NE 9 G1 > $- (#$mul"#ed &e)ve #e)m$&"l )ele"(e NE

7 G #o*e#!e)

> (o #!"# #!e e+e%# o- NE $& o(#(y&"#$%

de%)e"(e: BP de%)e"(e 0(y(#ol$% "&d

d$"(#ol$%1


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ADRENOCEPTOR BLOCKERα BLO!ERS

> &o& (ele%#$ve 0P!eol"m$&e 7

P!e&o5ye& ;"m$&e1 : lo%/ 26 "&d 23 )e%e#o)

> (ele%#$ve 26 lo%/e) 0P)";o($&1

" BLO!ERS

> P)o)"&olol

> B$(o)olol


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Non selective a receptor (locker :

> Blo%/ a) "&d a* )e%e#o)

> Blo%/ a* )e%e#o) %"& %"u(e$&%)e"(e

NE )ele"(e

> S#$mul"#e


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Selective +) receptor (locker :

> Sele%#$vely lo%/ 26 )e%e#o)

> Do &o# (#$mul"#e NE )ele"(e

> No #"%!y%")d$"


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< BLOCKERS

NON CARDIOSELECTI'E 0P)o)"&olol1CARDIOSELECTI'E 0Me#o)olol4 B$(o)olol1

PARTIAL AGONIST 8$#! ISA 0P$&dolol4A%eu#olol1

BLOCK 2 AND < RECEPTOR 0L"e#"lol1


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< BLOCKERSPROPR#NOLOL:

> E=%"%$ou( $& !ye)#e&($o& "&d $(%!em$"

!e")# d$(e"(e > U(ed $& m$ld #o mode)"#e !ye)#e&($o&

> I& (eve)e !ye)#e&($o&4 < lo%/e)( u(e-ul$&

)eve$&* #"%!y%")d$" y d$)e%# "%#$o&o- v"(od$l"#o) 0e*. ,yd)"l";$&e1


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Me%!"&$(m o- "%#$o&:

> Redu%e COP

> De%)e"(e v"(%ul") )e($(#"&%e > Redu%e A&*$o#e&($&


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'ASODILATORSORAL 'ASODILATORS: !yd)"l";$&e4 M$&o5$d$l

> u(ed -o) lo&* #e)m

PARENTERAL 'ASODILATORS : N$#)o)u(($de4D$";o5$de.

> u(ed #o #)e"# !ye)#e&($ve eme)*e&%$e(

CALCIUM C,ANNEL BLOCKERS 0CCB1:

Amlod$$&e4 'e)""m$l4 D$l#$";em

> u(ed $& o#! %$)%um(#"&%e(


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ANGIOTENSIN

ANTAGONIST#E INHIBITOR : C"#o)$l4 E&"l")$l

> A&*$o#e&($& II 7 Aldo(#e)o& lood level

)edu%e > B)"dy/$&$& )o"ly $&%)e"(e

> M$&$m"l %ome&("#o)y )e(o&(e

> S$de e+e%# : %ou*!

#NGIOTENSIN REEPTOR BLO!ER$#RB%& Lo(")#"&4 '"l(")#"&

#'( ote's '


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#'( ote's 'I

$i'acti)edeca*e*tid

e%

Brad+,i'i'$acti)e

)asodi-ator%

#'(iote'si'co')erti'(

e'z+me

#E I

I'acti)emeta.o-ite

#'(iote'si' II$acti)e

)asoco'strictor1

#T /

rece*tor

#T /rece*tor.-oc,ers


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The si0 a'tih+*erte'si)e

recomme'ded .+ 1HO:D$u)e#$%(

Be#" Blo%/e)(

ACE I(

CCB(

Al!" Blo%/e)(ARB(


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2o'othera*+

versus

Po-+*harmac+


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#d)a'ta(es o3 mo'othera*+P"#$e( mo)e %o&ve&$e 8$#!

mo&o#!e)"y

M"&y "#$e( do 8ell o& " ($&*led)u* $& m$ld mode)"#e!ye)#e&($o&

S$ml$%$#y e##e) %oml$"&%e

Le(( ($de e+e%#

I- ($de e+e%# do o%%u)4 #!eP! ($%$"& /&o8 #!e d)u


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3or the ma'a(eme't o3

h+*erte'sio'

Mo&o#!e)"y "# lo8 do(e

A%!$eved BP %o)ol Do &o# "%!$eved BP %o)o

%o$&uedAdded "&o#!e) %l"((

o- A, "*e

T$#)"#ed u8")d #o !$*!e) do(e

Th .- 3


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The *ro.-em o3mo'othera*+

Re(o&(e )"#e 8$#! 6 %l"(( o- A, $( lo8

?"(#e #!e #$me -o) #$#)"#ed do("*e

u8")d o) (8$#%! d)u* $& o)de) #o )e"%!*o"l BP

M"&y o- #!e %ommo& "dve)(e eve( ")edo(e dee&de

Come&("#o)y )e(o&(e

I&%)e"(ed )"#e o- "dve)(e eve le"d #ode%)e"(e "#$e %oml$"&%e

ye) e&( o


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ye) e&( o&

T)e"#me

De%)e"(ed Blood P)e((u)e

lo%/ed y lo%/edy d$u)e#$%( e#" lo%/e)

ACE I

I&%)e"(ed (ym"#!e#$%ou# @o8

0e)$!e)"l )e($(#"&%e1

Re&$& $&%)e"(ed0RAAS1

#"%!y%")d$" S"l# "&d w"#e))e#e$o&

I&%)e"(ed BP


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NC 'II0 o$ N"#$o&"l Comm$##ee Reo)# o& P)eve$o& De#e%#$o&4 Ev"lu"#$o& "&d

T)e"#me o- ,$*! Blood P)e((u)e 1

S#"*e I ,ye)#e&($o&0 6 6 1

Mo&o#!e)"y 8$#!#!$";$de 0 mo(# 14 ACEI4

ARB4 BB4 CCB

Poly!")m"%yCom$&"#$o& e#8ee& #!$";$de

"&d "#!e) %l"((

Poly!")m"%y3 d)u* %om$&"#$o& -o) mo(#u(u"lly T!$";$de "&d ACEI4

ARB4BB4CCB

No# "# *o"l BP

O#$m$;e do("*e(

Add "dd$#$o&"l d)u*(

S#"*e II,ye)#e&($o&0>6>61


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TERI2#!#SIH

lecture obat antihipertensi ppt

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