Antihypertensive Drugs for NEET PG: Classification and Drug-of-Choice Questions
Reflex · 17 Jun 2026 · 2 min read
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Antihypertensive questions in NEET PG rarely ask you to just list a drug class — they hand you a clinical scenario (pregnancy, post-MI, a diabetic with proteinuria) and ask which class is the right call. The classification is the easy part; matching class to scenario is where marks are actually won or lost.
Classification at a Glance
| Class | Examples |
|---|---|
| Thiazide diuretics | Hydrochlorothiazide |
| Loop diuretics | Furosemide |
| Potassium-sparing diuretics | Spironolactone |
| ACE inhibitors | Enalapril, Ramipril, Captopril |
| ARBs | Losartan, Telmisartan |
| Calcium channel blockers (dihydropyridine) | Amlodipine, Nifedipine |
| Calcium channel blockers (non-dihydropyridine) | Verapamil, Diltiazem |
| Beta blockers (cardioselective) | Atenolol, Metoprolol |
| Beta blockers (non-selective) | Propranolol |
| Combined alpha/beta blockers | Carvedilol, Labetalol |
| Centrally acting agents | Clonidine, Methyldopa |
| Direct vasodilators | Hydralazine, Minoxidil |
| Alpha blockers | Prazosin, Doxazosin |
Drug-of-Choice Scenarios Examiners Actually Ask
- Hypertension in pregnancy: Methyldopa is the classic drug of choice, alongside Labetalol and Nifedipine in many protocols. ACE inhibitors and ARBs are contraindicated in pregnancy due to fetotoxic effects, particularly in the second and third trimesters.
- Post-myocardial infarction: Beta blockers are first-line, both for their anti-ischemic effect and their mortality benefit.
- Diabetic with proteinuria: ACE inhibitors or ARBs are preferred for their renoprotective effect, independent of their blood-pressure-lowering action.
- Hypertensive emergency: Fast-acting IV agents (such as sodium nitroprusside or labetalol) are used, distinct from the oral agents used for chronic management.
Side Effects Worth Knowing Cold
- ACE inhibitors: dry cough (from bradykinin accumulation), hyperkalemia, angioedema.
- ARBs: similar to ACE inhibitors but without the cough, since they don’t affect bradykinin metabolism the same way.
- Non-dihydropyridine CCBs (Verapamil, Diltiazem): avoid combining with beta blockers — the combination risks severe bradycardia and heart block, since both depress AV conduction.
- Thiazides: hypokalemia, hyperglycemia, hyperuricemia (can precipitate gout).
Drug-of-choice questions are exactly the kind of applied pharmacology Reflex’s daily TROCAR quiz drills, subject by subject.
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FAQ
Frequently asked questions
The questions aspirants ask most about this topic.
Methyldopa is the classic first choice, with Labetalol and Nifedipine also commonly used. ACE inhibitors and ARBs are contraindicated.
Because they inhibit the breakdown of bradykinin, which accumulates and triggers cough — a mechanism ARBs don’t share.
Beta blockers, for both symptom control and mortality benefit.
It’s generally avoided — both slow AV conduction, and the combination risks significant bradycardia or heart block.
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