记忆口诀
"利钙肾，βRA；中枢扩，直接查；内皮拮，钠水压；心慢排，阻收缩"
一、详细分类与机制
以下为所有降压药的分类、代表药物及作用机制：
| 药物类别 | 代表药物 | 作用机制 | 快速记忆点 |
|---|---|---|---|
| 利尿剂 | 氢氯噻嗪、呋塞米 | 排钠排水，减少血容量，降低心输出量 | "排钠水，降血量" |
| 钙通道阻滞剂（CCBs） | 硝苯地平、氨氯地平 | 阻止钙离子内流，扩张血管平滑肌，减少外周阻力；非二氢吡啶类如维拉帕米降低心率 | "阻钙流，松血管；心慢排" |
| β受体阻滞剂 | 美托洛尔、比索洛尔 | 阻断β受体，降低心率、心排出量和肾素分泌 | "心慢排，肾素降" |
| α受体阻滞剂 | 哌唑嗪 | 阻断α1受体，扩张外周血管，降低血管阻力 | "挡α扩血管" |
| ACE抑制剂 | 依那普利、贝那普利 | 抑制血管紧张素转化酶，减少AngⅡ生成，降低血管收缩和醛固酮释放 | "ACE挡，松血管" |
| 血管紧张素受体拮抗剂（ARBs） | 氯沙坦、缬沙坦 | 阻断AngⅡ受体，减少血管收缩，降低醛固酮释放 | "阻受体，松血管" |
| 醛固酮受体拮抗剂 | 螺内酯、依普利酮 | 拮抗醛固酮受体，减少钠水潴留和血容量 | "抗醛压，利钾水" |
| 直接肾素抑制剂 | 阿利吉仑 | 抑制肾素活性，减少血管紧张素Ⅰ生成，间接减少AngⅡ | "抑肾素，压AngⅡ" |
| 直接扩血管药物 | 肼屈嗪、硝普钠 | 松弛血管平滑肌，扩张动脉（肼屈嗪）或静脉（硝普钠），降低外周阻力 | "平滑松，阻力降" |
| 中枢性降压药 | 可乐定、美卡瑞尔 | 激活中枢α2受体，减少交感神经活动，降低心率和血压 | "中枢抑，降交感" |
| α/β混合受体阻滞剂 | 拉贝洛尔、卡维地洛尔 | 同时阻断α1、β1和β2受体，扩张血管，降低心率和血管阻力 | "混阻滞，双降压" |
| 内皮素受体拮抗剂 | 波生坦、安立生坦 | 阻断内皮素受体，抑制血管收缩，扩张血管 | "抗内皮，松血管" |
| 钾通道开放剂 | 米诺地尔、地尔硫卓 | 激活钾通道，稳定血管平滑肌膜电位，扩张血管 | "开钾稳，松血管" |
| 硝酸酯类药物 | 硝酸甘油、单硝酸异山梨酯 | 释放一氧化氮（NO），激活鸟苷酸环化酶，松弛血管平滑肌，扩张静脉和动脉 | "NO松，双扩张" |
| 钠-葡萄糖共转运蛋白2（SGLT2）抑制剂 | 达格列净、恩格列净 | 通过降低血糖和尿钠排泄减少血容量，降低血压 | "抑SGLT，压钠糖" |
| 肾小管钠通道阻断剂 | 阿米洛利 | 阻断集合管ENaC通道，减少钠重吸收，保钾 | "挡钠通，保钾降" |
二、分组记忆
1. 调控血容量和心输出量
"利β钠心慢排"
利尿剂：减少血容量。
β受体阻滞剂：降低心率和心排出量。
肾小管钠通道阻断剂：减少钠重吸收，调节水钠平衡。
2. 直接作用于血管
"钙钾扩，硝平挡"
钙通道阻滞剂（CCBs）：抑制钙流。
钾通道开放剂：稳定膜电位。
直接扩血管药物：松弛平滑肌。
硝酸酯类：通过NO作用扩张血管。
3. 通过RAAS调节
"ACE阻，ARBs抗，抗醛压，抑肾素"
ACE抑制剂：阻断AngⅡ生成。
ARBs：拮抗AngⅡ受体。
醛固酮受体拮抗剂：减少钠水潴留。
直接肾素抑制剂：降低RAAS活性。
4. 通过神经调节
"中枢抑，αβ混"
中枢性降压药：减少交感神经活性。
α受体阻滞剂、α/β混合阻滞剂：降低交感兴奋。
5. 针对内皮和代谢
"内皮抗，SGLT抑"
内皮素受体拮抗剂：扩张血管。
SGLT2抑制剂：通过降尿钠和血糖调压。
三、综合记忆口诀
"利钙肾，βRA；中枢扩，直接查；内皮拮，钠水压；心慢排，阻收缩；开钾稳，NO双松"
Mnemonic for ALL Antihypertensive Drug Mechanisms
"Diuretics Balance Blood, Beta-Alpha Calm, RAAS Blocks Tension, Central Suppresses, Dilators Relax, Endothelium Stops Tightening, Potassium Opens Vessels, Nitrates and SGLT2 Lower Pressure!"
Complete Drug Classes and Their Mechanisms
| Drug Class | Examples | Mechanism | Quick Mnemonic |
|---|---|---|---|
| Diuretics | Hydrochlorothiazide, Furosemide | Excrete sodium and water, lowering blood volume and cardiac output | "Excrete Na⁺, reduce volume" |
| Calcium Channel Blockers | Amlodipine, Verapamil | Inhibit calcium influx, relaxing smooth muscles (dihydropyridines) and reducing heart rate (non-dihydropyridines) | "Block Ca²⁺, relax vessels" |
| Beta-Blockers | Metoprolol, Bisoprolol | Block β1-receptors, lowering heart rate, cardiac output, and renin secretion | "Slow HR, lower renin" |
| Alpha-Blockers | Prazosin, Doxazosin | Block α1-receptors, reducing peripheral resistance | "Block α, dilate vessels" |
| ACE Inhibitors | Enalapril, Ramipril | Block Angiotensin-Converting Enzyme (ACE), reducing Angiotensin II (Ang II) formation and aldosterone release | "ACE Blocks Ang II, reduces constriction" |
| ARBs | Losartan, Valsartan | Block Ang II receptors, preventing vasoconstriction and sodium retention | "Ang II Receptor Blocker" |
| Aldosterone Antagonists | Spironolactone, Eplerenone | Block aldosterone receptors, reducing sodium retention and potassium loss | "Block Aldosterone, K⁺ sparing" |
| Direct Renin Inhibitors | Aliskiren | Inhibit renin activity, reducing Ang I and Ang II production | "Inhibit renin, lower Ang II" |
| Direct Vasodilators | Hydralazine, Nitroprusside | Relax smooth muscle; Hydralazine targets arterioles, nitroprusside affects veins and arteries | "Relax vessels, reduce resistance" |
| Central Alpha Agonists | Clonidine, Methyldopa | Stimulate central α2-receptors, suppressing sympathetic outflow | "Suppress CNS, calm SNS" |
| Combined Alpha/Beta Blockers | Labetalol, Carvedilol | Block α1-, β1-, and β2-receptors, reducing vascular resistance and cardiac output | "Block both α and β" |
| Endothelin Receptor Antagonists | Bosentan, Ambrisentan | Block endothelin receptors, preventing potent vasoconstriction | "Stop endothelin, dilate" |
| Potassium Channel Openers | Minoxidil, Nicorandil | Open K⁺ channels, stabilizing vascular smooth muscle membranes, leading to vasodilation | "Open K⁺, relax vessels" |
| Nitrates | Nitroglycerin, Isosorbide Mononitrate | Release nitric oxide (NO), relaxing smooth muscle in veins and arteries | "NO relaxes veins and arteries" |
| SGLT2 Inhibitors | Empagliflozin, Dapagliflozin | Increase glucose and sodium excretion, reducing blood volume | "Excrete Na⁺ and sugar" |
| Sodium Channel Blockers | Amiloride | Block ENaC in collecting ducts, reducing sodium reabsorption while sparing potassium | "Block Na⁺ channel, spare K⁺" |
| Nitric Oxide Donors | Sodium Nitroprusside | Donate NO, directly activating guanylate cyclase to relax vascular smooth muscle | "Donates NO, relaxes all vessels" |
| Peripheral Dopamine Agonists | Fenoldopam | Activate dopamine D1 receptors, dilating peripheral arteries | "Dopamine dilates vessels" |
Categorized Mnemonics for Easy Recall
1. Targeting Volume and Output
"Diuretics & Beta Balance Volume"
Diuretics: Reduce blood volume via sodium excretion.
Beta-Blockers: Slow heart rate and reduce cardiac output.
2. Targeting Blood Vessel Resistance
"Calcium, Potassium, NO Relaxes"
CCBs: Inhibit calcium influx, relaxing smooth muscles.
Potassium Openers: Stabilize membrane potential, promoting relaxation.
Nitrates: Release NO, dilating arteries and veins.
3. Targeting the RAAS Pathway
"Renin, ACE, Ang II Block"
Direct Renin Inhibitors: Block renin to stop RAAS activation.
ACE Inhibitors: Block Ang I to Ang II conversion.
ARBs: Block Ang II receptors.
4. Central and Sympathetic Modulation
"Alpha-Calm, Beta-Calm"
Central Alpha Agonists: Suppress sympathetic outflow.
Alpha-Blockers: Reduce peripheral resistance.
Alpha/Beta Blockers: Reduce resistance and cardiac output.
5. Endothelial and Dopamine Modulation
"Stop Endothelin, Dilate Dopamine"
Endothelin Receptor Antagonists: Block endothelin, reducing vasoconstriction.
Dopamine Agonists: Activate D1 receptors to dilate arteries.
6. Metabolic Adjusters
"Excrete Na⁺ and Sugar"
SGLT2 Inhibitors: Increase glucose and sodium excretion, reducing blood volume.
Final Comprehensive Mnemonic
"Diuretics & Beta Calm Volume; RAAS Stops Tight; Calcium, Potassium, NO Relaxes; Central Suppresses, Endothelin Dilates, Sugar & Sodium Excrete!"
