stimulates α₂ adrenoceptors in vasomotor center; lowers TPR

depression, drowsiness, dry mouth, impaired ejaculation, false positive Coombs test, orthostatic hypotension

Primarily used for hypertension during pregnancy

Activate α2 adrenoceptors; reduces CO due to ↓HR and relaxation of capacitance vessels

Dry mouth, sedation, depression, Drowsiness

Impaired ejaculation

*Sudden withdrawal may lead to a hypertensive crisis*

Nonselective and noncompetitive antagonist of the nicotinic acetylcholine receptors

Severe orthostatic hypotension, constipation.

For very severe refractory hypertension

Depletes catecholamines from peripheral and central neurons, probably by interfering with VMAT

depression, drowsiness diarrhea, impaired ejaculation

sedation, rare parkinsonism symptoms

Depletes catecholamines from peripheral neurons; does not enter CNS

orthostatic hypotension,

diarrhea, impaired ejaculation

Block α₁ receptors on vasculature, inhibits vasoconstriction

first dose effect - orthostatic hypotension after first few doses

Hypertension, benign prostatic hyperplasia

blocks both β₁ and β₂ receptors; β₁ blockade decreases rate and force of heart contraction, ↓ CO

bradycardia, asthmatic attack, altered taste, fatigue with exercise, bronchoconstriction, depression, worsen Reynaud’s, decrease HDL, increase triglycerides

also used for angina, arrhythmias, migraine, stage fright

β1 selective blocker, partial agonist

Lower BP and HR

all of these more selective β₁ blockers can cause bradycardia and fatigue, but do not have the β₂ effects (e.g. worsening asthma and diabetes) 

Hypertension, arrhythmias, migraine

β₁ selective blocker

Lower HR and BP, reduce renin, may be safer in asthma

Bradycardia, fatigue, vivid dreams, cold hands

Hypertension, angina pectoris, arrhythmias

*All of these more selective β1 blockers can cause bradycardia and fatigue, but do not have the β2 effects (e.g. worsening asthma and diabetes)*

open K⁺ channels in vascular smooth muscle; dilates arterioles

hair growth (hirsutism),edema, cardiac tamponade,

pigmentation changes

Rogaine
oral med

causes formation of cyclic GMP; nitric oxide release; dilates arterioles but not veins

lupus-like syndrome after high doses or in slow acetylators

does not dilate coronary arteries, may actually compromise blood flow to the heart; oral med

open K⁺ channels in vascular smooth muscle; parenteral

decreases insulin secretion

hyperglycemia

given IV; hypertensive emergencies

Causes formation of cyclic GMP. Dilates both arteries and veins

 cyanide poisoning

DOC in hypertensive emergencies. Must be constituted just before use; given IV

Agonist of dopamine D₁ receptors resulting in dilation of peripheral arteries and natriuresis

Reflex tachycardia, headache, flushing, ↑ intraocular pressure

Hypertensive emergencies and postoperative hypertension

block calcium channels in vasculature; reduce vascular resistance

adverse cardiovascular events

verapamil, diltiazem have more cardiac effects, can be used as antiarrhythmics

Calcium channel blocker, dilates blood vessels

Hypertension, angina pectoris, arrhythmia

Inhibit angiotensin converting enzyme; reduces angiotensin II levels, ↓ vasoconstriction and aldosterone secretion, increases bradykinin (vasodilator)

Fetal abnormalities

Angioneurotic edema

Altered taste

Dry cough

Hypertension, heart failure

blocks angiotensin II receptors on vasculature, and blocks aldosterone secretion; no increase in bradykinin

Fetal abnormalities

Hypertension, heart failure

Inhibits enzyme activity of renin, reduces angiotensin I and II and aldosterone

Hyperkalemia, renal impairment, potential teratogen

Hypertension