Pharmacology - HYPERTENSION & ANTIHYPERTENSIVES (MADE EASY)

[@SpeedPharmacology]

🚀 Elevate Your Pharm Game! 📚 Join Patreon for A+ Study Notes! 👉 www.patreon.com/speedpharmacology 👈

[@nigelnyoni8265]

Hypertension: Blood pressure regulation: Blood pressure = force or tension of blood pressing against artery walls. It depends upon - left ventricle contraction - systemic vascular resistance - elasticity of arterial walls - blood volume Blood Pressure = Cardiac Output * Systemic Vascular Resistance . Arterial BP is regulated by pressure sensitive neurons (Baroreceptors) in Aortic arch and Carotid sinuses If BP drops, Baroreceptors send signals to adrenal medulla => catecholamine release => increased sympathetic activity via alpha and beta receptors. B1 receptor activation => increase heart rate and stroke volume = increased CO and ultimately BP A1 receptor activation on smooth muscle => vasoconstriction= increased vascular resistance = increased BP . RAA axis: Baroreceptors in kidneys respond to BP changes. renin secretion is stimulated by Decreased blood flow, and also by sympathetic B1 receptor activation in kidneys. Renin -> Angiotensin 2 production. AT2 is a potent vasoconstrictor of systemic blood vessels to raise peripheral resistance. It also constricts renal blood vessels. It also stimulates Aldosterone production Aldosterone => Sodium and H20 retention => increased blood volume => increased CO => increased BP . Antihypertensive Drugs: A1 blockers (ZOSINs) Beta blockers (LOLs) Centrally acting adrenergic drugs (clonidine & methyldopa) Calcium channel blockers (dihydropyridines & non-dihydro) Diuretics (loop, thiazide, K+ sparing) RAA axis blockers (Renin inhibitors, ACEi, ARBs) Nitrates Bosentan (Endothelin 1 antagonist) Fenoldopam (Dopamine 1 agonist) Hydralazine Minoxidil ... Alpha 1 blockers (Doxazosin & Prazosin) Block A1 receptors on smooth muscle to decrease systemic vascular resistance => decreased blood pressure Selective beta blockers (atenolol & metoprolol) Selectively block b1 receptors on the heart => decreased CO => decreased BP Non-selective beta blockers (labetalol & carvedilol) Block A1 receptors as well, simultaneously decreasing vascular resistance. Beta blockers block kidney b1, stopping RAA axis resulting in decreased systemic vascular resistance, and a drop in BP . Centrally acting adrenergic drugs Block sympathetic activity in the brain E.g. clonidine and methyldopa Clonidine selectively stimulates presynaptic a2 receptors providing negative feedback => reduced catecholamine prod & release => decreased systemic vascular resistance and CO and BP Methyldopa does the same as clonidine. It isn't an agonist yet. It's a prodrug that must be turned into active metabolite methyl-norepinephrine. . Calcium channel blockers: a. Dihydropyridines and b. non-dihydropyridines a. These selectively inhibit L-type calcium channels in vascular smooth muscle inhibiting contraction and decreasing resistance to blood flow and lowering blood pressure. Drugs are: Amlodipine, Felodipine, Nicardipine, Nifedipine. ADRs: Dizziness, headache, flushing, peripheral edema, gingival hyperplasia (all associated with vasodilation) b. They block calcium channels in vascular smooth muscle and also those on cardiac cells e.g. SA and AV nodes, producing reduced Contractility, slower heart rate, and slower conduction. They produce anti-arrythmic properties. Non-dihydropyridines don't significantly decrease CO as reflex tachycardia sets in due to vasodilation. Drugs are diltiazem and verapamil. ADRs : excessive bradycardia, cardiac conduction abnormalities. Verapamil can exert inhibition of Ça channels of smooth muscle in GI tract causing constipation. . Diuretics: i. Loop diuretics (e.g. furosemide) Reduce Na/Cl reabsorption in kidneys , causing significant diuresis. Decreased CO => decreased BP (especially In chronic kidney disease and volume based hypertension). ii. Thiazides (e.g. hydro-chloro-thiazide) reduce reabs of Na/Cl to a smaller degree than loop diuretics. Long term effects on blood volume are mininal. Sustained Antihypertensive effects are produced by thiazide-induced vasodilation. iii. K+ sparing diuretics (triamterene & Spironolactone) increase diuresis by disturbing Na/K exchange, or by blocking aldosterones actions. They're used in conjunction with the other 2 to reduce K+ loss. ... RAA axis blockers: Renin inhibitors decrease Angiotensin 2 production (aliskiren) ACEi inhibit Angiotensin 2 production and increase Bradykinin release. (PRILs) ARBs inhibit binding of Angiotensin 2 (SARTANs) These drugs decrease systemic vascular resistance without affecting cardiac output greatly. They reduce efferent arteriole vasoconstriction, so they improve renal blood flow, reducing risk of renal injury. ADRs: use can cause hyperkalemia (they inhibit aldosterone prod) ACEi can cause dry cough and angioedema (due to Bradykinin and substance P) ... Bosentan, competitive endothelin 1 antagonist. Acts on endothelin a and b receptors on pulmonary vascular cells. By blocking these it causes vasodilation, decreasing pulmonary vascular resistance. Indication: pulmonary hypertension. . Fenoldopam is a dopamine 1 receptor agonist on smooth muscle cells of peripheral vasculature, and renal, coronary, cerebral and mesenteric arteries. It produces generalised arterial vasodilation => decreased peripheral resistance => lower BP It inhibits tubular Na reabsorption => natriuresis & diuresis. Indication: short term management of severe hypertension (due to rapid Onset of action and short Duration of action). . Sodium nitroprusside and Nitroglycerin (sources of NO -> activates Guanyl cyclase=> increased cGMP => decreased Ca2+ => vasodilation) . Direct Acting smooth muscle relaxants: hydralazine and minoxidil. They produce compensatory reflex tachycardia, and Renin release, so are typically used with a diuretic and beta blocker

[@itz_sehaj_sidhu]

Thnx 😂for concised notes

[@abigailbotwe8106]

Thanks❤

[@genesisrobles3426]

My oldest son is in his early 20's and he has type 1 diabetes. But thank God for this piece of article kzbin.infoUgkxVYhghKWmrUgXARZ_ydZTvmmcrw5L0I5i At first he thought he had the flu and was lying down on the bed for three days until his sister took him to the hospital. They took his blood and it was 600. What I do not understand is how he could have gotten it, since no one in the family has it. But he is winning the battle now. This is good stuff.

[@Евантулеска]

In times of Corona, when a subject already difficult enough is made even more incomprehensible because its being taught online I'm thankful for youtube and pages like this!

[@w4laa]

KZbin is also teaching you things ONLINE

[@vivekanand9120]

We passed every exam by this before corona

[@babyandcatty]

PLEASE DO MORE TOPICS. THIS IS A LIFESAVER!!!!!

[@undrasmith1087]

This is one of the greatest blood pressure solution I`ve read BloodHeart.xyz Simple language is used to write it, meaning it is easy to understand and do. I strongly recommend this book for anyone wanting to lower her or his blood pressure. My blood returned to the normal 120/80 right after pursuing the suggestions on the program.

[@supunidissanayake7307]

Yeahhhh🥺💕💕💕

[@endawekeabere0506]

kzbin.info/door/z6yDm9pKj2ACnNlwPRNDJw

[@rahimathtoure7069]

Have no word to describe how useful your tutorials are,thank you so much professor.may God bless you ..

[@thechubbychloe]

I aced the phamacology module on our pharmacists board examination because of yoouu! 😭♥️ thankyouuuuu speed pharmacology. 🥰

[@suhairk6212]

Your videos deserve more views and likes! Thank you for putting the effort into it and for simplifying this topic.

[@attacktitan703]

Just so you know I get awfully sad when I search up a topic and you don't have a video on it. You're amazing!

[@dharmabum2838]

Huh? U dont have it but your amazing? Lol..uhh k

[@attacktitan703]

@@dharmabum2838 here you dropped this 🧠

[@panatypical]

This is a very useful refresher presentation for me, since I have been taking combinations of these medications for a number of years. Understanding their mechanisms of action often allows me to identify causation of changes in my conditions. I can then communicate more intelligently with my physicians.

[@davidlo168888]

Western medication forever can't effectively treat and revese hypertension. Forget those bullshit hypertensive drugs because they're of no use. How to reverse calcified and hardened internal elastic lamina? Western medication can't clear up AGEs (advanced glycation endproducts) so that vessels can restore their elasticity, flexibility and plasticity. God's mercy nano-medication is the last-ditch treatment for hypertension. Is it so amazing that to lower sys.pressure from 220 mm Hg to 110 mm Hg by nano-medication. Nano-medication is based on: God created humans out of extract of clay from ground During past five decades, USA, Russia, France and Germany have made great efforts to unravel nano-medication unsuccessfully. Nanoparticles of nano-medication are AGE-breakers and so-called Universal Ligand (Antibody) All glory belongs to God !

[@doctor8010]

Speed Pharmacology is a really excellelant inititiave may God Bless you Thank you Very much for enhancing the Knowledge

[@melindataylor8920]

I wish I had found these videos while I was taking pharmacology. You just put 4wks of frustration and confusion into a nice bubble for me as I am currently studying CV diseases, diagnoses and treatments. Thank you so much. I have already bookmarked the diabetes information for next month.

[@davidlo168888]

Western medication forever can't effectively treat and revese hypertension. Forget those bullshit hypertensive drugs because they're of no use. How to reverse calcified and hardened internal elastic lamina? Western medication can't clear up AGEs (advanced glycation endproducts) so that vessels can restore their elasticity, flexibility and plasticity. God's mercy nano-medication is the last-ditch treatment for hypertension. Is it so amazing that to lower sys.pressure from 220 mm Hg to 110 mm Hg by nano-medication. Nano-medication is based on: God created humans out of extract of clay from ground During past five decades, USA, Russia, France and Germany have made great efforts to unravel nano-medication unsuccessfully. Nanoparticles of nano-medication are AGE-breakers and so-called Universal Ligand (Antibody) All glory belongs to God !

[@homeoverb]

Great video. I just wanna make one small correction in the begging you say that renin is stimulating the convertion of angiotensin 1 -> angiotensin 2, this job is done by ACE(lungs). What renin does is to cleave Angiotensinogen made from the liver to Angiotensin 1

[@rahulsadhumbbs5124]

He said same think

[@lukasx543]

Here we have the smartest guy/girl of the class . He actually said Renin is necessary for the production of Angiotensin II . Then , later in the video he actually explains correctly the mechanism again . Be sure of double check something before you make a correction !

[@goffffret]

Thank you for the effort you put into these videos to help us!

[@lotofmedicine4861]

Key points ; BP=CO x Peripheral vascular resistance 1. Alpha-1 blockers : Decreasing SVP by vasodilation 2. Beta -2 blockers : Decreasing CO by decreasing heartbeat 3. [Centrally acting drugs on sympathetic system] ; By activating alpha 2 activation thus by decreasing Catecholamines[neurotransmitter] release. 4.Calcium Channel Blockers: BY inhibiting calcium channels on smooth muscles. 5.RAAS Mechanism blockers -a.Renin inhibitors b.ACE’s-Angiotensin convertase enzyme c.ARB’s- Angiotensin Receptor blockers 6.Diuretics -a.Loop b.Pottasium related affecting .

[@ethanalbrecht9352]

This really helps with understanding rather than memorizing. Thank you!

[@Gilke500]

You're a blessing, can't thank you enough for these videos. Pure gold!

[@kerryshante8492]

This simplified my revision.. thanks

[@rajwamanraosonwane1516]

I like the way you explains complicated concepts in a simple way

[@davidlo168888]

Western medication forever can't effectively treat and revese hypertension. Forget those bullshit hypertensive drugs because they're of no use. How to reverse calcified and hardened internal elastic lamina? Western medication can't clear up AGEs (advanced glycation endproducts) so that vessels can restore their elasticity, flexibility and plasticity. God's mercy nano-medication is the last-ditch treatment for hypertension. Is it so amazing that to lower sys.pressure from 220 mm Hg to 110 mm Hg by nano-medication. Nano-medication is based on: God created humans out of extract of clay from ground During past five decades, USA, Russia, France and Germany have made great efforts to unravel nano-medication unsuccessfully. Nanoparticles of nano-medication are AGE-breakers and so-called Universal Ligand (Antibody) All glory belongs to God !

[@emzeedawn9690]

explained conciselyyy as a visual learner. appreciate this much!

[@deniseb6215]

Look I have been on beta blockers for two years and this is the first time I’m understanding… I am pregnant and just got swapped from the Toprol to obey the law… Also swapped from the certain to hydralazine… They are trying to prevent pre-clamp Sia since I already had a high pressure… Anyway just wanted to say please do more videos your descriptions plus pictures make it very easy for nonmedical people LOL

[@R--zy1nb]

Can’t tell how good your explanation is!

[@christopherscott8822]

You are saving my life rn brother! Love your videos. Very simple yet everything I need to know!!! Keep up the good work

[@lydiatazdait7593]

Thank you so much for all your videos , please make more topics you're saving sooo many lives

[@abdulformouli4894]

An excellent and comprehensive presentation. May Allah save you longer to help medication longer and save human lives.god bless you.

[@kulbhattarai19]

Thank you so much for clear concept with figures. The figures make so easy to understand.

[@ilmaroseyanagiduquio9881]

Your channel has been very useful. Thank you for your free lecture. 😊

[@ilmaroseyanagiduquio9881]

Now working as a Pharmacist. Thank you again Speed pharmacology.

[@dulcedaynecelis6852]

This video is amazing. It discussed the major actions of the drugs at cellular level. Which is exactly what Im looking for!! ❤ Thank you so muchh! Please do more videos like this. Its easy to understand :)

[@Fuckalotgroup]

Tommorow I have exams on the renal system and this helped alot , you lot who is asking ren and hypertensive? oh well you guys have a fun life

[@mariadobielska4579]

I saw one video in polish on your channel, so let me ask if you are from Poland :) THANK YOU FOR YOUR WORK!

[@crudup246]

Can you make a video on diabetic drugs?

[@alex-ip1er]

hi everyone ,if anyone else trying to find out how to treat blood pressure try Nevolly Overcome BP Nerd ( search on google ) ? Ive heard some great things about it and my colleague got excellent success with it.

[@2361243]

That was very useful . Thanks a lot . You covered so many things in 15 mins .

[@abhishekvishwakarma3446]

One of best channel for pharmacologic Plz make more video sir

[@lizbethwalker6714]

After getting this t.co/GsO1JmyXtf for keeping blood pressure and looking it a week ago, I noticed the difference in my blood pressure levels. It definitely is stabilizing!!! After Twenty days of everyday use my blood pressure is down! Right after 25 days my pressure is normal (for me) 120/55.?

[@fos7237]

Lovely explanation, i will also recommend every individual to also check up on MFB pharmacology for a vivid explanation to this topic

[@ajar385]

🙏🙏🙏🙏🙏 eeeeeeeh who can thank me this person for such a beautiful explanation and understable video. We thirst for more sir😅

[@laraibnadeem1468]

Best vedio ever plz cover all the topics of pharma cology by urvedio

[@cje4664]

The best explanation of this that I've ever encountered ..... absolutely brilliant 👏 thank you!!!

[@kentwright5346]

Beutiful lecture. The review of physiollogy it very well done and is great preperation for the pharmacology section. Perfect.

[@storiesforfamily...6843]

Thanks for your effort Plz can u tell me name of good books about drug and diseases

[@fatimaalarabi5581]

You're a lifesaver man Thank you so much 🌸

[@charizmontminy9109]

Thank you so much for this! I was wondering if you'd make one for heart failure as well. That would be great!

[@journey7887]

How can be i thankful for this😭 Thank u so much sir. May Allah bless you

[@neetaspirant9671]

Thank you These videos are helping me a lot

[@NikoloskyH]

ACE inhibitors, which are used to lower blood pressure, increase bradykinin (by inhibiting its degradation), further lowering blood pressure.

[@happy_onigiri1068]

BEST PHARMACOLOGY CHANNEL!!

[@Qi33Qi]

Thank you so much for this video! It's been years since my cardiology module and This is a great refresher :)

[@akinosoboluwatife1759]

Thank you so much, you make pharmacology so interesting I must say.

[@estradevilalta]

U are a hero man. Finally medical drugs well explained. 🙏🏼

[@muhammadshanzaib8802]

Thank you so much . Excellent way to describe dry subject of pharmacology ❤️🙏. Love & respect from Pakistan 🇵🇰♥️

[@anakuzmanovska4735]

Best explained! Helps for my upcoming exams sooo much :D

[@jaspreetkaur6906]

Ur vedios are so helpful even before 2 days of exam 😊thank u so much for making these short vedios explaining complicated topics

[@umniyasal2969]

Can you please make a video on durgs for heart faliure? Your videos are very helpful and easy for learning.

[@najibaaah]

Thank you for existing in this world ❤️

[@princedragon800]

Thank you for making pharmacology easy

[@letsfun3069]

Ty for this LIFE SAVING lecture!!!!

[@sushrisova1827]

Can you make video about Antimicrobial drugs..It will very helpful for us... You're doing good 😊

[@ወኪዳንነኝ]

In short, fantastic ❤

[@user-wc3fd8hz4y]

Thank you so much. I wish i could press like button several times

[@pianodrummifier1691]

thank you Dr. doofinshmertz for explaining pharmacology to me

[@lparks488]

This was incredible! Thank you so much for simplifying :) !!!!

[@klepikovmd]

Good videos! As a pharmacology teacher, I often use it to help my students. Of commonly used drugs, there are no moxonidine. Is it not so common in your country?

[@SpeedPharmacology]

Personally I have not seen this drug used here in the U.S.

[@klepikovmd]

Speed Pharmacology interesting. It is used in Kazakhstan (and Europe) it is used as second line treatment. Looks like it doesn't have FDA approval.

[@rubina1868]

By far the best quick review...thank u

[@jazilaareen6629]

Thankyou so much! do you have other channels for other medical subjects too?

[@Yasharkeshvari]

Thank u for your hardwork , it means a lot for us as a pharmacy stu

[@sandeepkumarpatel6650]

Thank you soo much for making these kind of videos they soo easy to understand the subject.. Thank you☺😊

[@rainadavita]

thank you! this video help me to get through my exams.

[@kamrunnahar6681]

Please make more and more vedio in different topic of pharmacology , this is very helpful...

[@pharmacologysrdch3490]

its really great, do you use any app to create this kindof video,how did you make this video. i want to know to create for my students. kindly help me

[@noahatlasfaarabi8043]

Very good lecture there was some couple of questions about blood pressure i was wondering now i get the answer thanks for you 😃

[@phoenixn9950]

A LIFESAVER!!!!!! THANK YOU

[@saveenraj]

Plss watch the ads completely and support speed pharmacology. Thank u

[@hey_its_allan2437]

You just helped me in my pharmacology and biochemistry 😅😅. Thanks bro

[@vasavijagarapu]

Thank you...from one indian doctor for short revision 👍🏻

[@thephoenix85]

Very precise and very concise.. thankyou so much..

[@goddessdiaries8642]

Thank you 😊 God bless you

[@arshiyakhan8276]

please please do more topics..your vids are best!!!!!

[@nouranmasoud9214]

Thanks alot for adding Arabic translation ♥️💡

[@mustafoalhaddad349]

These videos are great

[@aseelmubarak190]

soooooooooooooooooooooo helpful. thank you so much.great video and explanation and images

[@hebaabdelsamie6381]

thank you I wish you add video about analgesic NSAID and antipsychotic drugs

[@Rahul31102]

NSAIDs video is available

[@Thatbutterflygal]

Saved my entire time Thnx a lot

[@أليناإقبال]

Thank you so much..Its very helpful..Plz do more videos..

[@irfanullah5157]

Happy teachers day from🇵🇰

[@giridv7300]

If we stop the production of any enzyme through a drug, how does the body react? Will it end up producing some other material? Alternatively what happens to the materials involved in the synthesis of the enzyme?

[@praveshmpharm]

Your videos are very good kindly upload more to cover other topics of pharmacology thanks

[@jerky7217]

darn well explained especially the RAAS, now i understand why ACE causes dry cough

[@isaacb.m.5397]

💯 MORE VIDEOS PLEASE 💯

[@gladysisrael3514]

Awesome!!!!!!! You have made my life easier. Thanks a lot. More videos pleaseeeeeee

[@a_peace_loving_man4953]

Please make more videos on cardiovascular drugs

[@faree38green]

Please can you do a series on contraceptives

[@caffeinatedcats]

I can't thank you enough for making these videos! Keep up the good work! :)

[@mbbstothepoint.8195]

Amazing lecture .cleared all concepts ..💗

[@anilaroorfatehi]

Thanks a lot,sir. May Allah bless you.🎉

[@dalyanadhum9208]

If I'm studying the katzung and trevor pharmacology, can I rely on these videos?? Please answer me.

[@zohaib1364]

Yup

[@sumitgupta4414]

very helpful.. thank you sir. please update calcium channel blockers detail pharmacology..thank you again

[@WILDWINGSMOFO]

I'm 13 and very interested in pharmacology and this is tough!

[@mahablue7386]

not for you go play with slime

[@saisrijasrija8635]

You are awesome,thank you so much

[@Ganpatibappa2010]

A treat to watch your video, Speed

[@anushapprabhu3537]

you my saviour well explained appreciate it god bless

[@rainbowpastel9215]

Love urvideos. You make it easy to understand

[@oculustertius4219]

Awesome video :) I have a question about methyldopa and clonide though. I understand that clonidine serves as an alfa-2 agonist in presynaptic neurons in the brain (however there is a dilemma as some sources it works on postsynaptic neurons? and other sources say it works not only in the brain- plz clarify) which therefore causes less release of NE,E-> less stimultion of alfa and beta = decreased blood pressure through a decrease in cardiac output + total peripheral resistance. However since normally we have compensatory mechanisms that prevent a decrease in blood pressure (baroreceptors) we would have reflex tachycardia but because clonidine works on receptors in nucleus solitarius and imidazole receptors (as an agonist?) these prevent the reflex from activating???? is this correct? How come clonidine is used in ADHD- apparently it raises norepinephrine levels in the prefrontal cortex (it doesnt make any sense since its an alfa-2 agonist so it should inhibit norepinephrine) and when it comes to methyldopa, i read that it is a L-dopa analogue. You say it is converted to an active metabolite which then works on alfa-2 receptors in presynaptic neurons = less NE+E (basically like clonidine). however since it is an analogue, it surely competes with L-dopa for the enzyme dopa decarboxylase, meaning less dopamine + noradrenaline is made-> this should be the main mechanism of action? or is it both???? HELP.

[@mashalahmad4705]

For the first question I was confuse too about the contradictory action of clonidine but then I did a little research and found that clonidine is indeed an alpha 2 adrenoreceptor agonist, but since alpha 2 receptors are autoregulators for NE release, the overall activity of sympathetic activity decreases because of less NE production. So it's a sort of agonist that works like an antagonist for the whole system. The same effect it has on central nervous system, decreasing the overall sympathetic outflow.

[@51-diyarohra90]

Alpha 2 receptors are inhibitory I.e they keep an inhibitory check , when the levels of NE increases in the synapse alpha 2 agonist will bind to the receptors and decrease the release of NE