Drug-Induced Arterial Hypertension I (Drugs acting on central and autonomic nervous system)

Written by Kun Imre Zoltán, Kun Ildikó, Kun Imre Zoltán jr., Szántó Zsuzsanna

The drugs inducing hypertensive effect were described and classified based on the physiological mechanisms that maintain normal blood pressure (BP). Most data refer to the substances acting on central and autonomic nervous system exerting predominant role in the regulation of BP. In the frame of sympatho-adrenergic system, among the direct sympathomimetic agents, there are first discussed the catecholamines, then the other direct acting predominantly alpha-, and alpha/beta-agonists, respectively, and finally the indirect sympathomimetics (amphetamines, tyramine, ephedrine etc.). We are focused on amphetamine-derivatives with anorectic and hypermetabolic actions, used in some countries to promote slimming diets, but we emphasize also the dangers of their use. There are discussed in detail the antidepressants which, although themselves rarely cause hypertension, through their many interactions often lead to serious hypertensive complications which must be prevented. The most serious consequence of these adverse interactions is the widely discussed serotonin syndrome, far less known among clinicians in this context. Are then described in detail the contraindicated drug combinations. Finally, there are summarized the most important therapeutic incompatibilities of the drugs that influence the central monoaminergic mechanisms. Description of cocaine and caffeine closes this paper. This theme will be continued in a further study regarding the medications that causes hypertension acting on the hormonal regulatory mechanisms of BP, and/or influencing the renal functions.


Keywords: direct and indirect sympathomimetics, amphetamine derivates, antidepressants, interactions, serotonine syndrome

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