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5 Pages

Pharmacology and Toxicology
Course Code
PHAR 100
Hisham Elbatarny

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Hypertension Blood Pressure (BP) • the force that the circulating blood exert on the walls of the arteries • the heart pumps out blood into different tissues through the arteries • circulating blood carries: ◦ nutrients and O2 to tissues ◦ waste and CO2 back to the heart Normal BP • systolic BP (SBP) = heart in contraction → ranges between 90 to 140 ← arterial(mediumsized) blood pressure • diastolic BP (DBP) = heart in relaxation → ranges between 60 to 90 Factors Controlling BP • blood volume: ◦ ↑ volume: ↑ BP ◦ ↓ volume: ↓ BP • peripheral resistance (PR) comes from friction in arterioles: ◦ vasoconstriction (VC): ↑ PR: ↑ BP ◦ vasodilatation (VD): ↓ PR: ↓ BP • sympathetic nervous system (SNS) activity: ◦ ↑ activity: ↑ noradrenaline: VC → ↑ BP ◦ ↓ activity: ↓ noradrenaline: VD → ↓ BP • renin-angiotensin system (most important) - reninenzyme released bykidneyWHEN blood Renin-angiotensin System pressure drops - reninconverts angiotensinogeninto angiotensinI - whichis thenconverted into angiotensinII, whichis helped bythe angiotensin-convertingenzyme (ACE) - angiotensinII: 1. causes vasoconstriction 2. stimulates adrenalgland to release aldosterone: causes saltAND water retention 3. stimulates release ofanti-diuretic hormone (ADH): causes water retension - end result:increased BP - problem:overstimulationofthis system→ hypertension High Blood Pressure • hypertension: need to do multiple measurements at different times to confirm hypertension ◦ PB > 140 / 90 • classification of hypertension: Risk Factors of Hypertension • non-controllable: age, male sex, family history • controllable: obesity, physical inactivity, smoking Diagnosis of Hypertension • usually asymptomatic (no symptoms) • based on measuring BP • complications: stroke, heart disease, renal damage, retinal damage Control of Hypertension • life long • ↓ incidence of complications • target values: ◦ hypertension alone: <140/90 ◦ hypertension + DM (diabetes): <130/80 → diabetes “enemy” to cardiovascular system too ◦ compliance Non-compliance • causes: ◦ dietary: e.g., high salt ◦ medication: e.g., costs, side effects, long term therapy • improvement: behavioral changes Treatment of Hypertension • non pharmacological measures • pharmacotherapy • treatment of complications Non Pharmacological Measures (Modification of Life Style) Dietary management: • reduce body weight • low salt diet • low fat diet • adequate amounts of: potassium, calcium and magnesium (good for heart and body) Change habits: • reduce alcohol consumption • stop smoking • regular exercise • stress management Pharmacotherapy (Antihypertensive Drugs) • diuretics: amount salt and water in urine • sympatholytics: inhibit sympathetic nervous system • calcium channel blockers (CCB): block Ca into cell • angiotensin converting enzyme inhibitors (ACEI) • angiotensin recept
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