Antihypotensive agent
An antihypotensive agent, also known as a vasopressor agent, is any medication that tends to raise reduced blood pressure.[1] Some antihypotensive drugs act as vasoconstrictors to increase total peripheral resistance, others sensitize adrenoreceptors to catecholamines - glucocorticoids,[2] and the third class increase cardiac output - dopamine, dobutamine.
If low blood pressure is due to blood loss, then preparations increasing volume of blood circulation—plasma-substituting solutions such as colloid and crystalloid solutions (salt solutions)[3]—will raise the blood pressure without any direct vasopressor activity. Packed RBCs, plasma or whole blood should not be used solely for volume expansion or to increase oncotic pressure of circulating blood.[4] Blood products should only be used if reduced oxygen carrying capacity or coagulopathy is present.[4] Other causes of either absolute (dehydration, loss of plasma via wound/burns) or relative (third space losses) vascular volume depletion also respond, although blood products are only indicated if significantly anemic.
Classification
Antihypotensive agents can be classified as follows:[5]
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- Sympathomimetics
- Epinephrine
- Noradrenaline hydrotartrate
- Phenylephrine ( Mesaton )
- Dobutamine
- Dopamine
- Ephedrine hydrochloride
- Midodrine
- Amezinium
- Myotropic drugs
- Angiotensinamide
- S-alkylisothiouronium derivatives
- Glucocorticoids and mineralocorticoids
- Analeptics
- Psychotropics
- Positive inotropic agents
- Cardiac glycosides
- Others
- Amrinone
- Milrinone
References
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