Which medications in the drug class Antihypertensives are used in the treatment of Acute Poststreptococcal Glomerulonephritis?

Updated: Dec 05, 2018
  • Author: Rajendra Bhimma, MBChB, MD, PhD, DCH (SA), FCP(Paeds)(SA), MMed(Natal); Chief Editor: Craig B Langman, MD  more...
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Answer

Antihypertensives

Antihypertensive agents are commonly used during initial phase of acute glomerulonephritis.

Amlodipine (Norvasc)

Amlodipine is generally regarded as a dihydropyridine, although experimental evidence suggests that it may also bind to the nondihydropyridine binding sites.

Amlodipine blocks postexcitation release of calcium ions into cardiac and vascular smooth muscle, thereby inhibiting the activation of ATPase on myofibril contraction. The overall effect is reduced intracellular calcium levels in cardiac and smooth muscle cells of the coronary and peripheral vasculature, resulting in dilatation of the coronary and peripheral arteries. This drug may also potentiate angiotensin-converting enzyme (ACE) inhibitor effects.

During depolarization, amlodipine inhibits calcium ions from entering the slow channels and voltage-sensitive areas of vascular smooth muscle and myocardium, which benefits nonpregnant patients with systolic dysfunction, hypertension, or arrhythmias. This agent a substantially longer half-life than nifedipine and diltiazem and is administered once daily.

Furosemide (Lasix)

Furosemide is a loop diuretic that is useful in patients with acute glomerulonephritis who are edematous. This agent also has some BP-lowering effect by increasing excretion of salt and water via interfering with the chloride-binding cotransport system in the ascending loop of Henle. In acute hypertensive states, administer furosemide intravenously (IV).

Labetalol (Trandate)

Labetalol blocks beta1-adrenergic, alpha-adrenergic, and beta2-adrenergic receptor sites, thereby decreasing BP.

Hydralazine

Hydralazine decreases systemic resistance through direct vasodilation of arterioles.

Nifedipine (Adalat, Procardia, Nifediac)

Nifedipine relaxes coronary smooth muscle and produces coronary vasodilation, which, in turn, improves myocardial oxygen delivery.

Nitroprusside (Nitropress)

Nitroprusside produces vasodilation and increases the inotropic activity of the heart. However, higher dosages may exacerbate myocardial ischemia by increasing the heart rate.


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