MOA

• CCB: works by blocking L-type calcium channels in vascular smooth muscle cells, leading to vasodilation, and reduced systemic vascular resistance. This mechanism results in lower blood pressure by relaxing blood vessels. Potential adverse effects include peripheral oedema and constipation.
• ARB: blocks the binding of angiotensin II to its receptors, preventing vasoconstriction and aldosterone release. This action leads to vasodilation, reduced blood pressure, and decreased sodium retention. Given the patient's persistently elevated blood pressure, consideration should be given to optimising this therapy or considering additional antihypertensive agents.
• • beta-blocker
  • blocks adreno-receptors causing a reduction in cardiac output
  • reduces renin secretion by antagonising betareceptors in the juxtaglomerular apparatus
  • results in decreased BP.
• • Metformin
  • biguanide
  • potentiates insulin action thereby decreasing hepatic glucose production
  • stimulates tissue uptake of glucose
  • delays gastric absorption of carbohydrates
• Loperamide

  synthetic opioid analogue which binds to opiate receptors in the gut wall

  reduces peristalsis, increases transit time, increases resorbption of water and electrolyte, reduces gut secretions, increases anal sphincter tone.
• Beta Blocker:

  beta1-selective-adrenoceptor blocker.

  Reduces HR and increases AV note refractoriness, this provides symptomatic improvement of AF symptoms. Also causes reduction in cardiac output.
• Clopidogrel

  binds specifically and irreversibly to the platelet P2RY12 purinergic receptor, inhibiting ADP-mediated platelet activation and aggregation
• Loop Diuretics


  Act on the ascending limb of the loop of Henle in the kidney, inhibit the reabsorption of sodium and chloride, leading to an increase in the excretion of water, sodium, chloride, and potassium, effective at reducing fluid overload
• Thiazide Diuretics


  Work in the distal convoluted tubule, inhibit sodium reabsorption, leading to increased excretion of sodium and water, commonly used to treat hypertension
• Potassium-Sparing Diuretics


  Act on the collecting ducts in the kidneys where they interfere with the exchange of sodium for potassium and hydrogen ions, reducing potassium and hydrogen secretion, and decreasing sodium reabsorption
• Statin: selectively inhibits HMG-CoA reductase in the liver

  preventing the formation of mevalonic acid, the rate-limiting step in the

  production of cholesterol. Thereby reduces the production of

  cholesterol.
• ACE inhibitor: acts by blocking the conversion of

  angiotensin I to angiotensin II (a potent vasoconstrictor) and

  stimulates the release of aldosterone. Therefore, ACE inhibitors cause

  vasoconstriction and reduction in salt and water retention thereby

  reducing peripheral resistance and reduced BP