Common Oral Antihypertensive Agents

Obat-Obat Anti Hipertensi

Table below lists the available antihypertensive medications. Although all of these classes of agents have been shown to be roughly equal in their ability to lower blood pressure in large population studies, they are not equally effective in all demographic groups or in preventing all complications. The initial choice for a given patient should take age, race, metabolic side effects, other cardiac risk factors and, most importantly, concomitant diseases into consideration.

The report of the Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure recommends monotherapy with diuretics or Beta-blockers as initial therapy. Calcium channel blockers, ACEIs, and ARBs, are alternative first-line agents. The report does recognize special populations, such as diabetic patients and patients with coronary disease, which need special consideration.

Drug Total Daily Dose1 (mg) Frequency Drug Total Daily Dose1 (mg) Frequency Adrenergic inhibitors   Calcium channel blockers    Alfa -Blockers    Diltiazem (SR) 120–160 Twice daily     Doxasosin 1–16 Once daily     (CD, XR) 120–160 Once daily      Prazosin 1–20 Two or three times daily    Verapamil 80–480 Two or three times daily      Terazosin 1–20 Once daily     (long-acting) 120–480 Once or twice daily   Beta-Blockers   Dihydropyridines      Atenolol 25–100 Once daily      Amlodipine 2.5–10 Once daily      Betaxolol 5–40 Once daily      Felodipine 5–20 Once daily      Bisoprolol 5–20 Once daily      Isradipine 2.5–10 Twice daily      Carvedilol 3.125–25 Twice daily      Nifedipine (GITS) 30–120 Once daily      Metoprolol 25–200 Twice daily      Nadolol 20–240 Twice daily Diuretics        Propranolol (long-acting) 60–240 Once daily   Thiazide–type     Bendroflumethiazide 2.5–5 Once daily      Timolol 20–40 Once daily     Benzthiazide 12.5–50 Once daily   Beta-Blockers with ISA      Chlorthalidone 12.5–50 Once daily      Acebutolol 200–1200 Once daily     Chlorthiazide 12.5–50 Once daily      Carteolol 2.5–10 Once daily     Hydroclorthiazide 12.5–50 Once daily      Penbutolol 20–80 Once daily      Indapamide 2.5–5 Once daily      Pindolol 10–60 Twice daily      Metolazone 1.25–5 Once daily   Alfa-Beta-Blockers      Methyclothiazide 2.5–5 Once daily      Labetalol 200–1200 Once or twice daily     Polythiazide 1.0–4 Once daily ACE inhibitors       Trichlormethiazide 1.0–4 Once daily      Benazepril 10–40 Once or twice daily   Loop diuretics      Captopril 25–50 Three times daily      Bumetanide 0.5–5 Twice daily      Enalapril 10–40 Once or twice daily      Furosemide 10–300 Twice daily      Fosinopril 10–40 Once or twice daily      Torsemide 2.5–10 Once daily      Lisinopril 10–40 Once or twice daily   Potassium-sparing agents      Moexipril 7.5–30 Once or twice daily      Amiloride 5–10 Once or twice daily     Perindopril 4–16 Once daily      Spironolactone 25–100 Two or three times daily      Quinapril 10–80 Once or twice daily      Triamterene 50–150 Once or twice daily      Ramipril 2.5–20 Once or twice daily      Trandolapril 1–8 Once daily Centrally acting agents      Clonidine 0.1–1.2 Once or twice daily Angiotensin receptor blockers       Transdermal 0.1–0.3 Once a week    Candesartan 2–32 Once daily    Guanabenz 4–64 Twice daily    Eprosartan 600–800 Once or twice daily    Methyldopa 250–2000 Twice daily    Irbesartan 75–300 Once daily    Losartan 25–100 Once or twice daily Peripheral vasodilators      Telmisartan 20–80 Once daily    Hydralazine 50–200 Once or twice daily    Valsartan 80–320 Once daily    Minoxidil 2.5–80 Once or twice daily

1The total daily dose should be given in divided doses at the frequency specified. The initial dose should be the smallest listed. ISA: intrinsic sympathomimetic activity

Referensi:
Current Diagnosis & Treatment Cardiology 3rd Edition (McGraw-Hill) 2009

Tags: Lecture Notes