Antihypertensives
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| 1st line therapy for Stage 1 HTN if no compelling indications | thiazide-type diuretic, OR ACEI, ARB, BB, CCB or combination
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| 1st line therapy for Stage 2 HTN if no compelling indications | thiazide-type diuretic AND ACEI, ARB, BB or CCB
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| 1st line therapy for HTN with compelling indications | diuretic, ACEI, ARB, BB, or CCB
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| two major types of centrally acting sympatholytics (sympatho-inhibitory) | Alpha2 receptor agonists; I1 (imidazoline) receptor agonists
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| eight types of peripherally acting sympatholytics (Vasodilators and RAAS Inhibitors) | Adrenergic Neuron Blockers, Alpha1 Receptor Blocker, Beta Receptor Blockers, Calcium Channel Blockers, Vasodilators, Angiotensin Converting Enzyme Inhibitors, Angiotensin Receptor Blockers, Renin Inhibitors
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| alpha-2 blockers (4) - centrally acting sympatholytics | Clonidine, Guanabenz, Guanfacine,Methyldopa
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| imidazoline receptor agonists (2) | Moxonidine, Relminidine
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| only one of the four alpha-2 blockers that is a prodrug | methyldopa - it must first be metabolized to alpha-methylnorepinephrine as shown below
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| Adrenergic Neuron Blocking Drugs (3) - peripherally acting sympatholytics | Reserpine, Guanethidine, Guanadrel
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| this adrenergic neuron blocking agent is long-acting and irreversible | reserpine
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| usually daily dose of reserpine | 0.25 mg PO
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| this adrenergic neuron blocking agent causes receptor supersensitivity | Guanethidine
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| alpha-1 receptor blockers (3) - peripherally acting sympatholytics | Prazosin, Terazosin, Doxazosin
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| these alpha-1 receptor blockers may cause "first-dose effect" consisting of hypotension and possibly syncope | Prazosin, Terazosin
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| selective B1 blockers without intrinsic activity | Atenolol, Betaxolol, Bisoprolol, Metoprolol
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| selective B1 blockers with intrinsic activity (ISA) | Acebutolol, Carteolol
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| non-selective beta-blockers without intrinsic activity | Nadolol, Propranolol, Timolol
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| non-selective beta-blockers with intrinsic activity | Penbutolol
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| alpha-1/beta-1 blocker | Carvedilol
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| alpha-1/beta-1/beta-2 blocker | Labetalol
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| beta-1 blocker/beta-2 agonist (not approved in US) | Nebivolol
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| beta-1 selective agonists | dobutamine, prenalterol
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| beta-2 selective agonists | ritodrine, terbutaline
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| calcium channel blockers approved for HTN | Amlodipine, Diltiazem (SR & ER only), Felodipine, Isradipine, Nicardipine, Nicardipine SR, Nicardipine IV (short term, Nifedipine ER, Nisoldipine, Verapamil, Verapamil SR & ER, Clevidipine IV infusion (approved for hypertensive emergency)
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| Vasodilators | Hydralazine, Nitroprusside, Organonitrates, Minoxidil, Diazoxide, Fenoldopam
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| Angiotensin Converting Enzyme Inhibitors | Captopril, Fosinopril, Enalapril, Quinapril, Ramipril, Lisinopril, Moexipril, Trandolapril, Benazepril, Perindopril
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| Angiotensin II (AT1) Receptor Antagonists | Losartan, Valsartan, Candesartan, Irbesartan, Telmisartan, Eprosartan, Olmesartan
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| daily dosing for prazosin | multiple daily dosing required (half-life of 3-4 hours due to first pass metabolism)
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| daily dosing for terazosin | 5 to 20 mg once daily
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| daily dosing for doxazosin | 1 mg once daily (lowest dose with once daily dosing duration of action)
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| nebivolol's additional mechanism of actin | beta-2 agonism in renal artery and glomerulus results in NO formation and dilation
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| IV infusion approved for hypertensive emergencies (CCB) | Clevidipine
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