RT Book, Section
A1 Gugelmann, Hallam Melville
A1 DeRoos, Francis Jerome
A2 Nelson, Lewis S.
A2 Howland, Mary Ann
A2 Lewin, Neal A.
A2 Smith, Silas W.
A2 Goldfrank, Lewis R.
A2 Hoffman, Robert S.
SR Print(0)
ID 1163013522
T1 Miscellaneous Antihypertensives and Pharmacologically Related Agents
T2 Goldfrank's Toxicologic Emergencies, 11e
YR 2019
FD 2019
PB McGraw-Hill Education
PP New York, NY
SN 9781259859618
LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1163013522
RD 2024/04/19
AB Hypertension  is  one  of  the  most  prevalent  chronic  medical  problems  and  one  of  the  most  readily  amenable  to  pharmacotherapy.  Antihypertensive  pharamacotherapeutics  were  first  used  in  the  1960s  after  two  studies  independently  linked  asymptomatic  hypertension  to  significant  adverse  effects  such  as  stroke,  myocardial  infarction  (MI),  and  sudden  death.74,92  The  first  antihypertensives  used  included  centrally  acting  sympatholytics,  direct  vasodilators,  sodium  nitroprusside,  and  diuretics.  Unfortunately,  these  often  had  significant  adverse  events,  leading  to  the  development  of  β-adrenergic  antagonists,  calcium  channel  blockers  (CCBs),  angiotensin-converting  enzyme  inhibitors  (ACEIs),  angiotensin  receptor  blockers  (ARBs),  and  direct  renin  inhibitors  (DRIs)  (Table  61-1).  This  chapter  reviews  early  antihypertensives,  as  well  ACEIs,  ARBs,  and  DRIs.  In  general,  the  majority  of  antihypertensives  manifest  clinical  signs  and  symptoms  in  terms  of  the  degree  of  hypotension  produced.  Particular  attention  will  be  placed  on  mechanisms  of  action  and  unique  toxicologic  considerations  for  each  of  these  xenobiotics.