The therapeutic effect of diuretics is based on their ability to promote increased elimination of water and sodium from the body. They are considered the first-line for treating hypertension. There are three main types of diuretics, which are thiazides, potassium-sparing diuretics, and loop diuretics. Thiazides act by inhibiting the absorption of sodium chloride in the distal convoluted tubule, loop diuretics work by selectively inhibiting the reabsorption of sodium chloride by acting on the sodium-potassium-chloride symporter in the loop of Henle, and potassium-sparing diuretics act on the collecting tubules to decrease reabsorption of sodium (Aronow, 2018).
The therapeutic action of ACE inhibitors is based on preventing the conversion of inactive angiotensin I to the active angiotensin II, which promotes the ACE inhibitors blood pressure lowing effect. They promote vasodilation, which prevents the narrowing of the blood vessels. Additionally, AC inhibitors also increase bradykinins and prostaglandins, which promotes reduction of blood pressure (Aronow, 2018).
ARBs work by blocking angiotensin II from binding to its respective receptor, which, in turn, prevents it from promoting vasoconstriction and fluid retention. The receptors are found on the muscles surrounding the blood vessels. The effect of ARBs in blocking angiotensin II promotes vasodilation, which in turn reduces the pressure of the blood. The effect of ARBs also reduces the effort the heart has to put in pumping the blood (Aronow, 2018).
Calcium channel blockers lower the blood pressure by preventing the entrance of calcium into the vascular smooth muscles. The effect of CCBs promotes vasodilation by reducing the contractibility of the blood vessels. Two types of CCBs exist, those that act on the peripheral blood vessels and those that act on both the peripheral blood vessels and cardiac muscles. While both of them are effective in managing hypertension, the nondihydropyridines, which act on both the cardiac muscles and peripheral blood vessels, are also effective in treating cardiac arrhythmias. Both types can be used as monotherapies in managing hypertension (Aronow, 2018).
Sympathetic Nervous System Drugs
These drugs function by activating the sympathetic nervous system as hypertension has been linked to different modifications of the functions of the SNS. The main drugs that have been proven effective in activating the SNS and modifying its functions include ACE inhibitors, CCBs, diuretics, and alpha-blockers.
Patient Education for Antihypertensive Medication
Patient education is important when prescribing or administering antihypertensive medication. Some of the considerations that patients should be educated on include the importance of adhering to their prescribed medication to promote its effectiveness in helping them control their blood pressure, and avoiding taking an extra dosage after forgetting to take their medication. Taking a higher dosage than the prescribed number of tablets can lower the blood pressure to very low point and increase the patient’s risk of complications or death. Other teaching points should incaalude the importance of talking to a physician before introducing another drug or supplement to the regimen to avoid drug-drug interactions and the need to report any adverse reactions that the patient might experience after using the drugs (Burnier & Egan, 2019). Taking these precautions seriously can reduce the risks of complications and promote effective management of hypertension.
Aronow, W. S. (2018). Antihypertensive drug therapy. Annals of Translational Medicine, 6(7), 123. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6015954/.Burnier, M., & Egan, B. M. (2019). Adherence in Hypertension: A Review of Prevalence, Risk Factors, Impact, and Management. Circulation Research, 124. 1124-1140. https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.118.313220.