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Hello guys how are you so guys we are going to continue our lecture on the treatment of hypertension so guys if you haven’t subscribed to our channel then still please subscribe our channel and click the bell icon so guys we were talking about that the cardiac output it can can be decreased by the diuretics but just a little decrease because only excretion will
Occur but still to any names is secretive and it will try to because we will we will only be giving one diuretics at the thighs i hope we cannot give all of them because he will have more side effects because we want some of the things to be absorbed as well so the iranian will reabsorb these sodium or water from some other part of the table you know the table
Is like this ascending and descending loop of henle someone absorb sodium someone absorb water if you want me to give a lecture on this also i can give you can just comment in the comment section so as what we will do for decreasing the diastolic pressure we we must block raining or angiotensin converting enzyme or angiotensin 2 or this angiotensin receptor and
You tension receptor so we have the drugs here ac inhibitor and you tension receptor blocker iranian iranian blocker but for the iranian blocker there is just one drug and it also have many side effects so usually the reigning blocker is not used okay only angiotensin receptor blocker you might have seen losartan ole miss horton who was hurt and this has been
Used but the first-line treatment is the ace inhibitor because of its less side effects and we have many defined categories so it is good you know been a cpl kept top rail and rail force in oprah lisinopril all these things so this one is the best to be used and it is the first-line treatment so let me tell you first line treatment as well which is the first-line
Diuretic is the loop diuretics loop diuretics anyone mostly used is for some id okay and ac inhibitor you have to do two drugs right because we also have to decrease the diastolic pressure so do pay rate ex and ace inhibitors are mostly used or you can say through some id plus captopril these are the first-line treatment of hypertension so in this way you can do
This you can decrease both diastolic ace inhibitor do what it will broke ac enzyme angiotensin will not be produced no one will constrict our trios and no one will cause secretion so definitely systolic blood pressure is decreasing and diastolic is also decreasing because systolic is not working we are giving diuretics and but we cannot block over all the time the
Alpha receptor as well because there are many alpha receptor in the body you know i just told you beat an alpha you cannot block the heart here on the beta receptor all the time because as most of the drug is also beta to blocker most drugs are with the beta blockers as we told here these are the beta blocker they just don’t only block b1 it also block b2 most
Of them only some of them like metroprolol the only bloke beta one but mostly it is dangerous so we only use beta blocker when someone has severe heart disease as well if someone has severe heart disease as well then we use beta one blocker so it will block here also and it is also present on kidney and it will blow both of these and because beta 2 is why beta
2 can t block because it is also present in bronchioles and if someone has a stoma then he has a problem and it is also present beta 1 is also present on the bladder as well beta 2 is also guess gip you can say and it decreased motility and then if we give it its person will also have diarrhea so it is not good to give with a blocker but if someone has severe
Heart disease only in heart disease heart disease you can give in severe heart disease is like a skimming heart disease supraventricular failure tachycardia anything like this okay so we don’t usually use beta blocker or alpha blocker as well because alpha receptors are also present on many sides of the body if we give alpha blocker like here alpha blocker it
Will block the alpha receptor but maybe it is also present in glt somewhere then it will also block it if you want the complete lecture on these because these are sympathetic sympathetic receptors you know alpha 1 adrenal receptor if you want a lecture on sympathetic receptor then you can comment in the comment section so this was all about it alpha receptor beta
Receptor but most importantly we use loop diuretics and ace inhibitors okay the most important things but some you know the inhibitor side side effects of curve and pure might also decrease the volumes and some causes ototoxicity hearing loss so these drugs are sometime dangerous and more dangerous in the pregnancy remember more dangerous in pregnancy so all the
Hypotensive drugs are content to get it in the pregnancy except only to drugs which are those two drugs methyl dopa and hydralazine only these two drugs can be used in pregnancy and there is no any other drug which should be used in the pregnancy remember and for other person you can use ace inhibitors loop diuretics beta blocker anything but the first line is is
Inhibitor and loop diuretics okay guys and there is another category hypertensive emergency if someone comes to and he has blood pressure above 200 by 120 and he’s having target organ damage or maybe sometimes and one no i don’t have organ damage and he’s in very serious condition then what you guys will do you will have to give hypertensive emergency drugs like
Nitroprusside nitroglycerin these nicotine it is a calcium channel blocker the calcium channel are also present on her tandoor every cell it is present and calcium will come in and it will cause more contractility more constriction okay but we don’t give calcium channel blockers mostly because what it will do it will decrease contractility of all the parts of the
Body so it is very dangerous if someone have a little bit higher dose and using it every time will make the person paralyzed so it is not cool to use calcium channel blockers but in severe cases in hypertensive emergency these two are calcium channel blockers and we are using it nitroglycerin is a nitric oxide as well and these drugs are available in intravenous
Form in i before so we use nitroglycerin as well and these are the all the these are adrian electric receptor blocker this is the most dangerous blocking thing if you want to block it will block every sympathetic stimulation every sympathetic stimuli will be blocked and these drugs will block every parasympathetic stimuli but at least at that time the person’s blood
Pressure will get down and he will be normal and he will don’t have any target organ damage so it is best sometime to use this and maybe someone also use calcium channel blocker as well but mostly labetalol is used a lot and nitro poisoning is also used clarity paint also any of these can be used and severe hypertensive emergency intravenously because if someone
Will come to you and he really want his blood pressure to go down for just one day or two day three days you can do it is not the type of drugs because hypertensive drugs should be used for lifetime someone has hyper-dense hypertension he must use those drugs for his whole life so it is better to give less side effects like ace inhibitor and loop diuretics so if
Someone has emergency then you can use this but only four three two days over a one one week okay but not every day so if someone comes to you with 200 by 120 blood pressure then you can just give him nitroglycerin or labetalol injection or clever tip in injection anything it will work okay so guys this was all about hypertensive drugs and in the next lecture i’m
Just going to give you guys some examples so you guys can understand it more clearly okay okay guys bye bye see you
Transcribed from video
Treatment of Hypertension-part.2 By Dr.Abdullah M.B.B.S
