Antihypertensive DDSs

Isosorbide Dinitrafe Hydralazine (BiDil) [Anrianginal, Antihypertensive/Vasodilator, Nitrate] Uses HF in African Amer-icans improve survival functional status, prolong time between hospitalizations Action Relaxes vascular smooth muscle peripheral vasodilator Dose Initially 1 tab tid PO (if not tolerated reduce to 1/2 tab dd), titrate >3-5 d as tolerated Max 2 tabs tid Caution [C, /—] recent MI, syncope, hypovolemia, hypotension, hep impair Contra For children, concomitant use w/ PDE5 inhibitors (sildenafil) Disp Tabs SE HA, dizziness, orthostatic hypotension, sinusitis, GI distress, tach, paresthesia, amblyopia Interactions T Risk of severe hypotension Wl antihypertensives, ASA, CCBs, MAOIs, phenothiazides, sildenafil, tadalafil, vardenafil, EtOH t pressor response W/ epi i effects Wl NSAIDs EMS Use ASA, antihypertensives and CCBs w/ caution, may T hypotension concurrent Viagra-type drug use can lead to profound hypotension concurrent EtOH use can T effects OD May cause N/V, profound hypotension, skin flushing, HA from ICP, bradycardia, confusion, and circulatory collapse activated charcoal may be effective, epi use is contraindicated... 

Methyldopa [Aldomet) [Antihypertensive/Centrally Acting Antiadrenergic] Uses HTN Action Centrally acting antihypertensive Dose Adults. 250-500 mg PO bid-dd (max 2-3 g/d) or 250 mg-1 g IV q6-8h Peds. 10 mg/kg/24 h PO in 2-3 + doses (max 40 mg/kg/24 h - q6-l2h) or 5-10 mg/kg/dose IV q6-8h to total dose of 20—40 mg/kg/24 h i in renal insuff/elderly Caution [B (PO), C (IV), +] Contra Liver Dz MAOIs Disp Tabs, inj SE Discolors urine inidal transient sedadon/drowsiness frequent, edema, hemolydc anemia, hepadc disorders Interactions T Effects W/ anesthetics, diuredcs, levodopa, Li, methotrimeprazine, thioxanthenes, vasodilators, verapamil T effects OF haloperidol, Li, tolbutamide 1 effects W7amphetamines, Fe, phenothiazine, TCAs 1 effects OF ephedrine EMS Use diuredcs, verapamil, and sympathomimedcs w/ caudon may T risk hypotension, arrhythmias and pressors effects OD May cause profound hypotension, drowsiness, and impaired myocardial conduction activated charcoal may be effective... 

Astragalus [Astragalus membranaceus) Uses Rx of resp infxns, enhancement of immune system, HF Action Root saponins T diuresis, BP anti-inflammatory action related to the stimulation of macrophages, T antibody formation T T-lymphocyte proliferation Available forms Caps/tabs 1-4 g ticl, PO Liq ext 4-8 mL/d (1 2 rado) dry ext 250 mg (1 8 ratio) dd, PO Notes/SE Immunosuppression w/ doses >28 g Interactions T Effect OF acyclovir, anticoagulants, antihypertensives, antithrombotics, antipits, interleukin 2, interferon i effect OF cyclophosphamide EMS T Risk of bleeding... 

Weber MA, Drayer JI, Brewer DD, Lipson JL. Transdermal continuous antihypertensive therapy. Lancet 1984 1(8367) 9-11. 

Maki DD, Ma JZ, Louis TA, Kasiske BL. Long-term effects of antihypertensive agents on proteinuria and renal function. Arch Intern Med 1995 155 1073-1080. 

Chitosan is known to have many biological activities, which are affected by MW or chain length and DD. Therefore, desired properties of chitosan or its derivatives that are necessary to exhibit different biological activities can be obtained by chemical and enzymatic modification. In this chapter, antihypertensive actions of chitosan and its derivatives are discussed. 

---