Antihypertensive Drugs - Comprehensive Summary

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// DATA
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const slides = [
  {
    title: "💊  THIAZIDE & THIAZIDE-LIKE DIURETICS",
    color: C.sky,
    drugs: [
      {
        name: "Hydrochlorothiazide (HCTZ)",
        dose: "12.5–25 mg once daily",
        comorbidities: "Essential HTN, Osteoporosis, Isolated systolic HTN, Elderly",
        sideEffects: "Hypokalemia, Hyponatremia, Hyperuricemia, Hyperglycemia, Hyperlipidemia, Photosensitivity",
        contraindications: "Anuria, Sulfonamide allergy, Gout (relative), Hypokalemia",
      },
      {
        name: "Chlorthalidone",
        dose: "12.5–25 mg once daily",
        comorbidities: "Essential HTN, Cardiovascular risk reduction, Metabolic syndrome",
        sideEffects: "Hypokalemia, Hyponatremia, Hyperuricemia, Hyperglycemia, Impotence",
        contraindications: "Anuria, Sulfonamide allergy, Severe renal impairment (GFR <30)",
      },
      {
        name: "Indapamide",
        dose: "1.25–2.5 mg once daily",
        comorbidities: "Essential HTN, Diabetes (metabolically neutral), Heart failure",
        sideEffects: "Mild hypokalemia, Headache, Dizziness (less metabolic effects than HCTZ)",
        contraindications: "Severe hepatic impairment, Hypokalemia, Anuria",
      },
    ],
  },
  {
    title: "💊  LOOP DIURETICS",
    color: C.indigo,
    drugs: [
      {
        name: "Furosemide (Frusemide)",
        dose: "20–80 mg once or twice daily (oral); 20–40 mg IV bolus",
        comorbidities: "Hypertension with renal insufficiency (GFR <30), Heart failure, Pulmonary edema, Hypercalcemia",
        sideEffects: "Hypokalemia, Hyponatremia, Hypomagnesemia, Ototoxicity (high IV doses), Hyperuricemia, Dehydration",
        contraindications: "Anuria, Sulfonamide allergy (furosemide), Pre-renal azotemia, Hepatic coma",
      },
      {
        name: "Bumetanide",
        dose: "0.5–2 mg once or twice daily",
        comorbidities: "HTN + CKD, Resistant edema, Heart failure",
        sideEffects: "Hypokalemia, Ototoxicity, Muscle cramps, Hyperuricemia",
        contraindications: "Anuria, Sulfonamide allergy, Severe electrolyte depletion",
      },
      {
        name: "Torsemide",
        dose: "5–20 mg once daily",
        comorbidities: "Heart failure, CKD-related HTN, Resistant HTN",
        sideEffects: "Hypokalemia, Dizziness, Headache (less ototoxic than furosemide)",
        contraindications: "Anuria, Sulfonamide allergy, Hepatic cirrhosis (use with caution)",
      },
    ],
  },
  {
    title: "💊  POTASSIUM-SPARING DIURETICS / MRA",
    color: C.teal,
    drugs: [
      {
        name: "Spironolactone",
        dose: "12.5–100 mg once daily (HTN); 25–50 mg in HF",
        comorbidities: "Heart failure (HFrEF), Resistant HTN (4th agent), Primary Hyperaldosteronism, Conn syndrome",
        sideEffects: "Hyperkalemia, Gynecomastia, Menstrual irregularities, Impotence, GI upset",
        contraindications: "Hyperkalemia (K+ >5.5), Anuria, Addison's disease, Concurrent ACEi/ARB (risk of hyperkalemia)",
      },
      {
        name: "Eplerenone",
        dose: "25–50 mg once or twice daily",
        comorbidities: "Post-MI HTN + LV dysfunction, Heart failure, Primary Hyperaldosteronism",
        sideEffects: "Hyperkalemia, Dizziness, Fatigue (less gynecomastia than spironolactone)",
        contraindications: "K+ >5.5 mEq/L, eGFR <30, Diabetes with microalbuminuria, Strong CYP3A4 inhibitors",
      },
      {
        name: "Amiloride / Triamterene",
        dose: "Amiloride: 5–10 mg/day; Triamterene: 50–100 mg/day",
        comorbidities: "Combined with thiazide to prevent K+ loss, Hypokalemia prevention",
        sideEffects: "Hyperkalemia, Nausea, Renal stones (triamterene), Megaloblastic anemia",
        contraindications: "Hyperkalemia, Renal insufficiency, Use with ACEi/ARBs or other K+ sparing agents",
      },
    ],
  },
  {
    title: "💊  BETA-BLOCKERS (β-Blockers)",
    color: C.coral,
    drugs: [
      {
        name: "Metoprolol Succinate (β1-selective)",
        dose: "25–200 mg once daily (ER)",
        comorbidities: "Post-MI, Angina, HFrEF, Atrial fibrillation (rate control), Hyperthyroidism, Anxiety (perioperative)",
        sideEffects: "Bradycardia, Fatigue, Cold extremities, Bronchospasm, Hyperglycemia (masking), Depression, Impotence",
        contraindications: "Asthma/COPD, 2nd/3rd degree AV block, Cardiogenic shock, Raynaud's phenomenon, Decompensated HF",
      },
      {
        name: "Bisoprolol (β1-selective)",
        dose: "2.5–10 mg once daily",
        comorbidities: "HFrEF, Post-MI, Angina, AF rate control, HTN + Stable COPD (use cautiously)",
        sideEffects: "Bradycardia, Fatigue, Cold extremities, Sexual dysfunction, Sleep disturbance",
        contraindications: "Severe asthma, AV block (2nd/3rd degree), Sick sinus syndrome, Cardiogenic shock",
      },
      {
        name: "Carvedilol (α+β blocker)",
        dose: "3.125–25 mg twice daily",
        comorbidities: "HFrEF, Post-MI with LV dysfunction, HTN + HF, Diabetes (vasodilatory β-blocker)",
        sideEffects: "Orthostatic hypotension, Bradycardia, Dizziness, Fluid retention, Fatigue",
        contraindications: "Decompensated HF, Severe hepatic impairment, Severe bradycardia, Asthma",
      },
      {
        name: "Labetalol (α+β blocker)",
        dose: "100–400 mg twice daily (oral); 20–80 mg IV bolus",
        comorbidities: "HTN in pregnancy (2nd/3rd trimester), Hypertensive crisis, Perioperative HTN, Aortic dissection",
        sideEffects: "Orthostatic hypotension, Scalp tingling, Nausea, Bronchospasm, Fatigue",
        contraindications: "Asthma, Cardiogenic shock, Bradycardia, Pre-eclampsia with high vagal tone",
      },
    ],
  },
  {
    title: "💊  ACE INHIBITORS (ACEi)",
    color: C.green,
    drugs: [
      {
        name: "Ramipril",
        dose: "2.5–10 mg once or twice daily",
        comorbidities: "Post-MI (HOPE trial), Diabetic nephropathy, CKD + Proteinuria, HFrEF, CVD risk reduction",
        sideEffects: "Dry cough (10–20%), Hyperkalemia, Angioedema (rare, 0.1%), First-dose hypotension, Acute kidney injury (bilateral RAS)",
        contraindications: "Pregnancy (teratogenic), Bilateral RAS, History of ACEi-induced angioedema, Hyperkalemia (K+>5.5)",
      },
      {
        name: "Lisinopril",
        dose: "5–40 mg once daily",
        comorbidities: "Essential HTN, Diabetes + microalbuminuria, CKD, Post-MI, HFrEF, Stroke prevention",
        sideEffects: "Dry cough, Hyperkalemia, Angioedema, Hypotension (first dose), Rash, Dysgeusia",
        contraindications: "Pregnancy, Bilateral RAS, Prior ACEi angioedema, Hyperkalemia, Do NOT combine with ARB",
      },
      {
        name: "Enalapril / Perindopril",
        dose: "Enalapril: 5–40 mg/day ÷ 1–2 doses; Perindopril: 4–8 mg once daily",
        comorbidities: "Essential HTN, CAD, HFrEF, LVH reduction, Elderly with CVD risk",
        sideEffects: "Dry cough, Angioedema, Hyperkalemia, Elevated creatinine (early, usually benign)",
        contraindications: "Pregnancy, Prior angioedema, Concurrent ARB use (dual RAS blockade), Hyperkalemia",
      },
    ],
  },
  {
    title: "💊  ANGIOTENSIN RECEPTOR BLOCKERS (ARBs)",
    color: C.gold,
    drugs: [
      {
        name: "Valsartan",
        dose: "80–320 mg once daily",
        comorbidities: "Essential HTN, Post-MI LV dysfunction, HFrEF (if ACEi intolerant), Diabetic nephropathy",
        sideEffects: "Hyperkalemia, Dizziness, Hypotension, Elevated creatinine (usually benign), Rare angioedema",
        contraindications: "Pregnancy (teratogenic), Bilateral RAS, Hyperkalemia, Concurrent ACEi, Concurrent aliskiren (in diabetes/CKD)",
      },
      {
        name: "Losartan",
        dose: "25–100 mg once or twice daily",
        comorbidities: "Essential HTN, Diabetic nephropathy (RENAAL trial), HFrEF, Marfan syndrome (aortic dilation)",
        sideEffects: "Dizziness, Hyperkalemia, Back/leg pain (unique to losartan), Mild cough (much less than ACEi)",
        contraindications: "Pregnancy, Bilateral RAS, Hyperkalemia, Concurrent ACEi or aliskiren",
      },
      {
        name: "Telmisartan / Olmesartan",
        dose: "Telmisartan: 40–80 mg/day; Olmesartan: 20–40 mg/day",
        comorbidities: "Essential HTN with metabolic syndrome (telmisartan – PPAR-γ partial agonist), AF prevention, Stroke prevention",
        sideEffects: "Hyperkalemia, Dizziness, Olmesartan: sprue-like enteropathy (rare but severe)",
        contraindications: "Pregnancy, Bilateral RAS, Hyperkalemia, Concurrent ACEi; Olmesartan in bile duct obstruction",
      },
    ],
  },
  {
    title: "💊  CALCIUM CHANNEL BLOCKERS (CCBs)",
    color: C.violet,
    drugs: [
      {
        name: "Amlodipine (DHP – arterial)",
        dose: "2.5–10 mg once daily",
        comorbidities: "Essential HTN, Elderly, Asymptomatic atherosclerosis, Angina, LVH, Isolated systolic HTN, PAD",
        sideEffects: "Peripheral edema (ankle), Flushing, Headache, Reflex tachycardia, Gingival hyperplasia",
        contraindications: "Cardiogenic shock, Severe aortic stenosis (relative), Unstable angina (short-acting DHP)",
      },
      {
        name: "Nifedipine Extended Release (DHP)",
        dose: "30–90 mg once daily (ER only – IR is contraindicated for chronic HTN)",
        comorbidities: "HTN, Angina, Raynaud's phenomenon, Esophageal spasm, Preterm labor (tocolysis)",
        sideEffects: "Peripheral edema, Flushing, Headache, Tachycardia, Constipation",
        contraindications: "Cardiogenic shock, Acute MI (immediate release), Combined with grapefruit (CYP3A4 inhibition)",
      },
      {
        name: "Diltiazem (Non-DHP – cardiac)",
        dose: "120–360 mg once daily (ER); 30–60 mg 4× daily (IR)",
        comorbidities: "HTN + Angina (vasospastic/stable), AF rate control, Subarachnoid hemorrhage vasospasm prevention",
        sideEffects: "Bradycardia, AV block, Constipation, Peripheral edema, Hypotension",
        contraindications: "Sick sinus, 2nd/3rd AV block, HFrEF, Concurrent β-blocker (risk of complete AV block), WPW",
      },
      {
        name: "Verapamil (Non-DHP – cardiac)",
        dose: "80–120 mg 3× daily (IR); 120–240 mg twice daily (SR)",
        comorbidities: "HTN + AF rate control, PSVT, Cluster headache (prophylaxis), Hypertrophic obstructive cardiomyopathy",
        sideEffects: "Severe constipation, Bradycardia, AV block, Hypotension, Negative inotropy",
        contraindications: "Concurrent β-blocker, HFrEF (severe depression of function), AV block, WPW with AF, Cardiogenic shock",
      },
    ],
  },
  {
    title: "💊  ALPHA-1 BLOCKERS  |  CENTRAL ALPHA-2 AGONISTS",
    color: C.orange,
    drugs: [
      {
        name: "Doxazosin (α1-blocker)",
        dose: "1–16 mg once daily (start 1 mg to minimize first-dose hypotension)",
        comorbidities: "HTN + BPH (dual benefit), Resistant HTN (adjunct), Pheochromocytoma preparation (phenoxybenzamine preferred)",
        sideEffects: "First-dose orthostatic hypotension, Dizziness, Fatigue, Palpitations, Peripheral edema",
        contraindications: "NOT as monotherapy (ALLHAT trial: increased HF risk), Concurrent phosphodiesterase-5 inhibitors",
      },
      {
        name: "Clonidine (central α2-agonist)",
        dose: "0.1–0.8 mg 2–3× daily; TTS patch: 0.1–0.3 mg/24h (weekly)",
        comorbidities: "Resistant HTN, HTN urgency, Opioid/alcohol withdrawal, ADHD, Menopausal flushing",
        sideEffects: "Sedation, Dry mouth, Bradycardia, Constipation, Rebound hypertension on withdrawal, Depression",
        contraindications: "Sudden discontinuation (rebound crisis), Sick sinus syndrome, AV block; caution with β-blockers",
      },
      {
        name: "Methyldopa (central α2-agonist)",
        dose: "250–500 mg 2–3× daily (max 3g/day)",
        comorbidities: "PREGNANCY-INDUCED HYPERTENSION (1st choice), HTN in chronic kidney disease",
        sideEffects: "Sedation, Dry mouth, Autoimmune hemolytic anemia (Coombs+), Hepatotoxicity, Impotence, Hyperprolactinemia",
        contraindications: "Active hepatic disease, Prior methyldopa-related hepatitis, Concurrent MAO inhibitors, Pheochromocytoma",
      },
    ],
  },
  {
    title: "💊  DIRECT VASODILATORS  |  SPECIAL SITUATIONS",
    color: "8B5CF6",
    drugs: [
      {
        name: "Hydralazine",
        dose: "25–100 mg 2–4× daily (oral); 5–20 mg IV/IM (pregnancy/crisis)",
        comorbidities: "HTN in pregnancy (pre-eclampsia), HFrEF (with nitrates), Resistant HTN (add-on)",
        sideEffects: "Reflex tachycardia (must use with BB), Drug-induced lupus (>200 mg/day), Fluid retention, Headache, Flushing",
        contraindications: "Coronary artery disease (reflex tachycardia worsens ischemia), SLE, Mitral valve rheumatic disease",
      },
      {
        name: "Minoxidil",
        dose: "2.5–100 mg once or twice daily (rarely used – expert only)",
        comorbidities: "Resistant HTN (3–4 drugs failed), HTN + Renal failure",
        sideEffects: "Severe reflex tachycardia, Fluid retention/edema, Hirsutism (hair growth – topical use), Pericardial effusion",
        contraindications: "Pheochromocytoma, Acute MI, Must combine with diuretic + β-blocker to prevent fluid/HR side effects",
      },
      {
        name: "Sodium Nitroprusside (IV)",
        dose: "0.3–10 mcg/kg/min IV infusion (titrated to effect)",
        comorbidities: "Hypertensive EMERGENCY, Acute aortic dissection, Severe HF (afterload reduction), Post-op HTN",
        sideEffects: "Cyanide/thiocyanate toxicity (prolonged use/renal failure), Profound hypotension, Reflex tachycardia, Methemoglobinemia",
        contraindications: "Compensatory HTN (AV shunt), Hepatic failure (cyanide accumulation), Vitamin B12 deficiency",
      },
    ],
  },
];

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      { text: "Preferred Agents", options: { bold: true, color: C.white, fill: { color: C.navy }, fontSize: 9 } },
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      { text: "🫀 Post-MI / CAD", options: { fill: { color: "FFE4E8" }, fontSize: 8 } },
      { text: "ACEi, ARB, β-blocker (bisoprolol / metoprolol / carvedilol)", options: { fill: { color: "FFE4E8" }, fontSize: 8 } },
      { text: "Non-DHP CCBs (depress LV function)", options: { fill: { color: "FFE4E8" }, fontSize: 8 } },
      { text: "Ramipril 2.5–10 mg/day", options: { fill: { color: "FFE4E8" }, fontSize: 8 } },
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      { text: "💓 Heart Failure (HFrEF)", options: { fill: { color: "FFF0E4" }, fontSize: 8 } },
      { text: "ACEi/ARB, BB (bisoprolol/carvedilol), MRA, Loop diuretic", options: { fill: { color: "FFF0E4" }, fontSize: 8 } },
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    [
      { text: "🩺 Diabetes Mellitus", options: { fill: { color: "E4F9F5" }, fontSize: 8 } },
      { text: "ACEi, ARB, CCB (amlodipine), Thiazide (low dose)", options: { fill: { color: "E4F9F5" }, fontSize: 8 } },
      { text: "β-blockers (mask hypoglycemia), High-dose thiazide", options: { fill: { color: "E4F9F5" }, fontSize: 8 } },
      { text: "Lisinopril 5–40 mg; Amlodipine 5–10 mg", options: { fill: { color: "E4F9F5" }, fontSize: 8 } },
    ],
    [
      { text: "🫘 CKD / Proteinuria", options: { fill: { color: "E8F4FD" }, fontSize: 8 } },
      { text: "ACEi / ARB (first-line – reduce proteinuria), Loop diuretics (if GFR <30)", options: { fill: { color: "E8F4FD" }, fontSize: 8 } },
      { text: "Thiazides (ineffective GFR <30), K+-sparing (hyperkalemia risk)", options: { fill: { color: "E8F4FD" }, fontSize: 8 } },
      { text: "Valsartan 80–320 mg; Furosemide 20–80 mg", options: { fill: { color: "E8F4FD" }, fontSize: 8 } },
    ],
    [
      { text: "🧠 Stroke Prevention", options: { fill: { color: "F0E8FD" }, fontSize: 8 } },
      { text: "ACEi (perindopril), ARB, Thiazide/thiazide-like", options: { fill: { color: "F0E8FD" }, fontSize: 8 } },
      { text: "Abrupt BP lowering in acute stroke", options: { fill: { color: "F0E8FD" }, fontSize: 8 } },
      { text: "Perindopril 4–8 mg + Indapamide 1.25 mg (PROGRESS)", options: { fill: { color: "F0E8FD" }, fontSize: 8 } },
    ],
    [
      { text: "🤰 Pregnancy", options: { fill: { color: "FFF5E4" }, fontSize: 8 } },
      { text: "Methyldopa (safest), Labetalol, Nifedipine ER, Hydralazine (IV)", options: { fill: { color: "FFF5E4" }, fontSize: 8 } },
      { text: "ACEi, ARBs (teratogenic – category D/X), Atenolol (IUGR)", options: { fill: { color: "FFF5E4" }, fontSize: 8 } },
      { text: "Methyldopa 250–500 mg BD; Labetalol 100–400 mg BD", options: { fill: { color: "FFF5E4" }, fontSize: 8 } },
    ],
    [
      { text: "🫁 Asthma / COPD", options: { fill: { color: "E4F9E4" }, fontSize: 8 } },
      { text: "ACEi/ARB, CCB (amlodipine), Thiazide", options: { fill: { color: "E4F9E4" }, fontSize: 8 } },
      { text: "β-blockers (bronchospasm), ACEi cough can mimic asthma", options: { fill: { color: "E4F9E4" }, fontSize: 8 } },
      { text: "Amlodipine 5–10 mg; Losartan 25–100 mg", options: { fill: { color: "E4F9E4" }, fontSize: 8 } },
    ],
    [
      { text: "🚨 Hypertensive Emergency", options: { fill: { color: "FFE0E0" }, fontSize: 8 } },
      { text: "IV Labetalol, IV Nicardipine, IV Nitroprusside, IV Enalaprilat", options: { fill: { color: "FFE0E0" }, fontSize: 8 } },
      { text: "Rapid correction >25% in 1hr (end-organ ischemia)", options: { fill: { color: "FFE0E0" }, fontSize: 8 } },
      { text: "Reduce MAP by ≤25% in first hour, then to 160/100 over 2–6h", options: { fill: { color: "FFE0E0" }, fontSize: 8 } },
    ],
    [
      { text: "🫀 Atrial Fibrillation (Rate Control)", options: { fill: { color: "E4F0FF" }, fontSize: 8 } },
      { text: "β-blocker, Non-DHP CCBs (diltiazem, verapamil)", options: { fill: { color: "E4F0FF" }, fontSize: 8 } },
      { text: "DHP CCBs (do not control rate), Digoxin (only in sedentary patients)", options: { fill: { color: "E4F0FF" }, fontSize: 8 } },
      { text: "Diltiazem 120–360 mg/day; Metoprolol 25–200 mg/day", options: { fill: { color: "E4F0FF" }, fontSize: 8 } },
    ],
    [
      { text: "🔷 BPH + Hypertension", options: { fill: { color: "FFF0FA" }, fontSize: 8 } },
      { text: "α1-blockers (doxazosin, terazosin) – treat both", options: { fill: { color: "FFF0FA" }, fontSize: 8 } },
      { text: "As sole antihypertensive (ALLHAT – inferior outcomes); use as adjunct", options: { fill: { color: "FFF0FA" }, fontSize: 8 } },
      { text: "Doxazosin 1–16 mg/day (start low)", options: { fill: { color: "FFF0FA" }, fontSize: 8 } },
    ],
    [
      { text: "🔴 Pheochromocytoma", options: { fill: { color: "FFE8DC" }, fontSize: 8 } },
      { text: "Phenoxybenzamine (irreversible α-blocker), then add β-blocker", options: { fill: { color: "FFE8DC" }, fontSize: 8 } },
      { text: "β-blocker FIRST (will cause hypertensive crisis due to unopposed α)", options: { fill: { color: "FFE8DC" }, fontSize: 8 } },
      { text: "Phenoxybenzamine 10 mg BD, titrate up; Propranolol added after α-block", options: { fill: { color: "FFE8DC" }, fontSize: 8 } },
    ],
  ];

  s.addTable(tableData, {
    x: 0.15, y: 1.2, w: 13, h: 6.1,
    border: { pt: 0.5, color: "C5D5E4" },
    autoPage: false,
    colW: [2.0, 3.5, 3.2, 4.3],
  });

  // footer
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 7.15, w: 13.3, h: 0.35,
    fill: { color: C.navy }, line: { type: "none" } });
  s.addText("Antihypertensive Drug Reference  |  For Educational Use", {
    x: 0.2, y: 7.15, w: 13, h: 0.35,
    fontSize: 7.5, color: C.white, fontFace: "Calibri", valign: "middle",
  });
}

// ═══════════════════════════════════════════════════════════════════════════
// LAST SLIDE: KEY PRINCIPLES
// ═══════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.background = { color: C.navy };

  s.addShape(pres.shapes.OVAL, { x: -1, y: -1, w: 5, h: 5,
    fill: { color: C.teal, transparency: 80 }, line: { type: "none" } });
  s.addShape(pres.shapes.OVAL, { x: 10, y: 4, w: 4, h: 4,
    fill: { color: C.coral, transparency: 80 }, line: { type: "none" } });

  s.addText("KEY PRESCRIBING PRINCIPLES", {
    x: 0.4, y: 0.3, w: 12.5, h: 0.75,
    fontSize: 28, bold: true, color: C.gold, fontFace: "Calibri",
  });

  const points = [
    { icon: "①", text: "First-line preferred classes: ACEi / ARB + CCB + Thiazide diuretic (as single-pill combination where possible)", col: C.sky },
    { icon: "②", text: "β-Blockers are added as 4th drug in resistant HTN, or when specific indication exists (HF, post-MI, AF)", col: C.coral },
    { icon: "③", text: "NEVER combine ACEi + ARB – dual RAS blockade increases adverse effects without added benefit", col: "FF6B6B" },
    { icon: "④", text: "NEVER combine BB + non-DHP CCB – risk of complete AV block and cardiogenic shock", col: "FF6B6B" },
    { icon: "⑤", text: "ACEi & ARBs are teratogenic (Category D/X) – switch to methyldopa or labetalol before or during pregnancy", col: C.gold },
    { icon: "⑥", text: "Resistant HTN (BP above goal on 3 drugs incl. diuretic): add spironolactone 12.5–50 mg/day as 4th agent", col: C.teal },
    { icon: "⑦", text: "Trough-to-peak ratio >50% required – choose agents with long half-lives for once-daily dosing compliance", col: C.green },
  ];

  points.forEach((p, i) => {
    s.addShape(pres.shapes.RECTANGLE, {
      x: 0.3, y: 1.25 + i * 0.78, w: 0.45, h: 0.62,
      fill: { color: p.col }, line: { type: "none" },
    });
    s.addText(p.icon, {
      x: 0.3, y: 1.25 + i * 0.78, w: 0.45, h: 0.62,
      fontSize: 14, bold: true, color: C.white, fontFace: "Calibri",
      align: "center", valign: "middle", margin: 0,
    });
    s.addText(p.text, {
      x: 0.85, y: 1.28 + i * 0.78, w: 12.2, h: 0.6,
      fontSize: 11, color: C.white, fontFace: "Calibri",
      valign: "middle", wrap: true,
    });
  });
}

// Write file
pres.writeFile({ fileName: "/home/daytona/workspace/antihypertensives/Antihypertensives_Drug_Chart.pptx" })
  .then(() => console.log("SUCCESS: file written"))
  .catch(e => { console.error("ERROR:", e); process.exit(1); });

"""
Antihypertensive Quick-Reference Pocket Card
A5 landscape (148 x 210 mm) – 4 pages, print-ready
Uses ReportLab only (pre-installed).
"""

from reportlab.lib.pagesizes import A5, landscape
from reportlab.lib import colors
from reportlab.lib.units import mm
from reportlab.platypus import (
    SimpleDocTemplate, Table, TableStyle, Paragraph,
    Spacer, HRFlowable, KeepTogether
)
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.enums import TA_CENTER, TA_LEFT, TA_RIGHT
from reportlab.platypus import PageBreak
from reportlab.pdfgen import canvas as pdfcanvas
from reportlab.lib.colors import HexColor, white, black
import os

# ── output path ────────────────────────────────────────────────────────────
OUT = "/home/daytona/workspace/antihypertensives/Antihypertensives_Pocket_Card.pdf"
PAGE = landscape(A5)          # 210 x 148 mm  (595 x 420 pt)
W, H = PAGE
M = 10 * mm                    # margin

# ── colour palette ─────────────────────────────────────────────────────────
NAVY    = HexColor("#0D1B2A")
TEAL    = HexColor("#1B998B")
CORAL   = HexColor("#E84855")
GOLD    = HexColor("#F4A261")
VIOLET  = HexColor("#7B2D8B")
SKY     = HexColor("#2196F3")
GREEN   = HexColor("#27AE60")
ORANGE  = HexColor("#E67E22")
PINK    = HexColor("#D63384")
INDIGO  = HexColor("#3949AB")
WHITE   = white
LTGRAY  = HexColor("#F4F7FB")
MIDGRAY = HexColor("#CBD5E1")
DARKTEXT= HexColor("#1A1A2E")
RED_WARN= HexColor("#FF3B30")

CLASS_COLORS = {
    "Thiazides":        SKY,
    "Loop Diuretics":   INDIGO,
    "K-Sparing/MRA":    TEAL,
    "Beta-Blockers":    CORAL,
    "ACE Inhibitors":   GREEN,
    "ARBs":             GOLD,
    "CCBs":             VIOLET,
    "Alpha-1 Blockers": ORANGE,
    "Central Agonists": PINK,
    "Vasodilators":     HexColor("#8B5CF6"),
}

# ── helper: background canvas callback ─────────────────────────────────────
def page_bg(canvas, doc):
    canvas.saveState()
    # header bar
    canvas.setFillColor(NAVY)
    canvas.rect(0, H - 18*mm, W, 18*mm, fill=1, stroke=0)
    # thin gold accent strip
    canvas.setFillColor(GOLD)
    canvas.rect(0, H - 20*mm, W, 2*mm, fill=1, stroke=0)
    # footer bar
    canvas.setFillColor(NAVY)
    canvas.rect(0, 0, W, 7*mm, fill=1, stroke=0)
    # footer text
    canvas.setFillColor(WHITE)
    canvas.setFont("Helvetica", 6)
    canvas.drawCentredString(W/2, 2.2*mm,
        "Antihypertensive Pocket Reference  |  For Clinical & Educational Use  "
        "|  Sources: Goodman & Gilman's, Katzung's, Family Medicine 9e")
    # header title
    canvas.setFillColor(WHITE)
    canvas.setFont("Helvetica-Bold", 13)
    canvas.drawString(M, H - 13*mm, "ANTIHYPERTENSIVE DRUGS  —  Clinical Pocket Reference")
    canvas.setFont("Helvetica", 8)
    canvas.setFillColor(GOLD)
    canvas.drawRightString(W - M, H - 13*mm, f"Page {doc.page}")
    canvas.restoreState()

# ── styles ─────────────────────────────────────────────────────────────────
styles = getSampleStyleSheet()

def S(name, **kw):
    return ParagraphStyle(name, **kw)

hdr1 = S("hdr1", fontName="Helvetica-Bold", fontSize=9, textColor=WHITE,
          leading=11, spaceAfter=1)
body = S("body", fontName="Helvetica", fontSize=7.2, textColor=DARKTEXT,
         leading=9.5, spaceAfter=1)
bold7 = S("bold7", fontName="Helvetica-Bold", fontSize=7.5, textColor=DARKTEXT,
          leading=9.5)
warn = S("warn", fontName="Helvetica-Bold", fontSize=6.8, textColor=RED_WARN,
         leading=9)
small = S("small", fontName="Helvetica", fontSize=6, textColor=HexColor("#64748B"),
          leading=8)
section_title = S("sttl", fontName="Helvetica-Bold", fontSize=8.5,
                  textColor=NAVY, leading=11, spaceBefore=4, spaceAfter=2)
combo_ok = S("cok", fontName="Helvetica", fontSize=7, textColor=GREEN, leading=9)
combo_no = S("cno", fontName="Helvetica-Bold", fontSize=7, textColor=RED_WARN, leading=9)

# ── data ───────────────────────────────────────────────────────────────────
# Each drug block:  class, color, [(drug, dose, comorbidities, side_effects, contraindications)]
DRUG_DATA = [
    ("Thiazides", SKY, [
        ("Hydrochlorothiazide", "12.5–25 mg OD",
         "HTN, osteoporosis, elderly, isolated systolic HTN",
         "Hypokalemia, hyponatremia, hyperuricemia, hyperglycemia",
         "Anuria, sulfonamide allergy, gout, GFR <30"),
        ("Chlorthalidone", "12.5–25 mg OD",
         "HTN, CV risk reduction, metabolic syndrome",
         "Hypokalemia, hyperuricemia, impotence",
         "Anuria, sulfonamide allergy, severe renal impairment"),
        ("Indapamide", "1.25–2.5 mg OD",
         "HTN + diabetes (metabolically neutral), HF",
         "Mild hypokalemia, headache (less metabolic SE)",
         "Severe hepatic impairment, hypokalemia"),
    ]),
    ("Loop Diuretics", INDIGO, [
        ("Furosemide", "20–80 mg OD/BD oral; 20–40 mg IV",
         "HTN + CKD (GFR <30), HF, pulmonary oedema, hypercalcaemia",
         "Hypokalemia, hyponatremia, ototoxicity (high IV dose), dehydration",
         "Anuria, sulfonamide allergy, pre-renal AKI"),
        ("Torsemide", "5–20 mg OD",
         "HF-related HTN, CKD, resistant HTN",
         "Hypokalemia, dizziness (less ototoxic than furosemide)",
         "Anuria, hepatic cirrhosis (caution)"),
    ]),
    ("K-Sparing/MRA", TEAL, [
        ("Spironolactone", "12.5–50 mg OD (HTN); 25–50 mg HF",
         "Resistant HTN (4th agent), HFrEF, Conn syndrome, primary hyperaldosteronism",
         "Hyperkalemia, gynecomastia, menstrual irregularities",
         "K+ >5.5, anuria, Addison's disease; avoid with ACEi+ARB combo"),
        ("Eplerenone", "25–50 mg OD/BD",
         "Post-MI + LV dysfunction, HFrEF, primary hyperaldosteronism",
         "Hyperkalemia, dizziness (less gynaecomastia)",
         "K+ >5.5, eGFR <30, strong CYP3A4 inhibitors"),
    ]),
    ("Beta-Blockers", CORAL, [
        ("Metoprolol succinate", "25–200 mg OD (ER)",
         "Post-MI, angina, HFrEF, AF rate control, hyperthyroidism",
         "Bradycardia, fatigue, bronchospasm, cold extremities, hyperglycemia masking",
         "Asthma/COPD, 2nd-3rd AV block, cardiogenic shock, decompensated HF"),
        ("Bisoprolol", "2.5–10 mg OD",
         "HFrEF, post-MI, angina, AF rate control",
         "Bradycardia, fatigue, sexual dysfunction, sleep disturbance",
         "Severe asthma, AV block, sick sinus, cardiogenic shock"),
        ("Carvedilol (α+β)", "3.125–25 mg BD",
         "HFrEF, post-MI + LV dysfunction, HTN + HF",
         "Orthostatic hypotension, bradycardia, fluid retention",
         "Decompensated HF, severe hepatic impairment, asthma"),
        ("Labetalol (α+β)", "100–400 mg BD; 20–80 mg IV bolus",
         "HTN in pregnancy, hypertensive crisis, aortic dissection",
         "Orthostatic hypotension, scalp tingling, nausea, bronchospasm",
         "Asthma, cardiogenic shock, bradycardia"),
    ]),
    ("ACE Inhibitors", GREEN, [
        ("Ramipril", "2.5–10 mg OD/BD",
         "Post-MI (HOPE), diabetic nephropathy, CKD + proteinuria, HFrEF, CVD risk reduction",
         "Dry cough (10-20%), hyperkalemia, angioedema (0.1%), hypotension (1st dose)",
         "Pregnancy (teratogenic), bilateral RAS, prior ACEi angioedema, K+ >5.5"),
        ("Lisinopril", "5–40 mg OD",
         "Essential HTN, DM + microalbuminuria, CKD, post-MI, stroke prevention",
         "Dry cough, hyperkalemia, angioedema, rash, dysgeusia",
         "Pregnancy, bilateral RAS, prior ACEi angioedema; do NOT combine with ARB"),
        ("Perindopril", "4–8 mg OD",
         "HTN, CAD, HFrEF, LVH reduction, elderly + CVD risk",
         "Dry cough, angioedema, hyperkalemia",
         "Pregnancy, prior angioedema, concurrent ARB (dual RAS blockade)"),
    ]),
    ("ARBs", GOLD, [
        ("Losartan", "25–100 mg OD/BD",
         "HTN, diabetic nephropathy (RENAAL), HFrEF (ACEi-intolerant), Marfan syndrome",
         "Dizziness, hyperkalemia, back/leg pain (losartan-specific), minimal cough",
         "Pregnancy (teratogenic), bilateral RAS, K+ >5.5; do NOT combine with ACEi"),
        ("Valsartan", "80–320 mg OD",
         "HTN, post-MI LV dysfunction, HFrEF, diabetic nephropathy",
         "Hyperkalemia, dizziness, hypotension, mildly elevated creatinine",
         "Pregnancy, bilateral RAS, K+ >5.5, concurrent ACEi or aliskiren"),
        ("Telmisartan", "40–80 mg OD",
         "HTN + metabolic syndrome (PPAR-γ partial agonist), AF prevention, stroke prevention",
         "Dizziness, hyperkalemia, upper respiratory infection",
         "Pregnancy, bilateral RAS, bile duct obstruction, K+ >5.5"),
    ]),
    ("CCBs", VIOLET, [
        ("Amlodipine (DHP)", "2.5–10 mg OD",
         "Essential HTN, elderly, asymptomatic atherosclerosis, angina, isolated systolic HTN, PAD",
         "Peripheral oedema (ankle), flushing, headache, reflex tachycardia, gingival hyperplasia",
         "Cardiogenic shock, severe aortic stenosis (relative), unstable angina with short-acting DHP"),
        ("Nifedipine ER (DHP)", "30–90 mg OD (ER ONLY)",
         "HTN, angina, Raynaud's, preterm labour (tocolysis)",
         "Peripheral oedema, flushing, headache, tachycardia",
         "Acute MI (IR form), cardiogenic shock; avoid grapefruit (CYP3A4)"),
        ("Diltiazem (non-DHP)", "120–360 mg OD (ER); 30–60 mg QID (IR)",
         "HTN + angina (vasospastic/stable), AF rate control",
         "Bradycardia, AV block, constipation, peripheral oedema",
         "Sick sinus, 2nd-3rd AV block, HFrEF, concurrent β-blocker, WPW"),
        ("Verapamil (non-DHP)", "80–120 mg TDS; 120–240 mg BD (SR)",
         "HTN + AF rate control, PSVT, cluster headache prophylaxis, HOCM",
         "Severe constipation, bradycardia, AV block, negative inotropy",
         "Concurrent β-blocker (complete AV block), HFrEF, AV block, WPW with AF"),
    ]),
    ("Alpha-1 Blockers", ORANGE, [
        ("Doxazosin", "1–16 mg OD (start 1 mg)",
         "HTN + BPH (dual benefit), resistant HTN (add-on)",
         "First-dose orthostatic hypotension, dizziness, palpitations, peripheral oedema",
         "NOT as monotherapy (ALLHAT trial); avoid with PDE-5 inhibitors (severe hypotension)"),
        ("Prazosin", "1–10 mg BD-TDS",
         "HTN, PTSD nightmares (off-label), pheochromocytoma (adjunct)",
         "First-dose syncope, dizziness, nasal congestion, fluid retention",
         "Avoid as sole antihypertensive; caution with other antihypertensives"),
    ]),
    ("Central Agonists", PINK, [
        ("Clonidine", "0.1–0.8 mg BD-TDS; patch 0.1–0.3 mg/24h (weekly)",
         "Resistant HTN, HTN urgency, opioid withdrawal, ADHD",
         "Sedation, dry mouth, bradycardia, constipation, rebound HTN on abrupt withdrawal",
         "Abrupt discontinuation (rebound crisis); caution with β-blockers, sick sinus, AV block"),
        ("Methyldopa", "250–500 mg BD-TDS (max 3 g/day)",
         "PREGNANCY HTN (1st choice), CKD-related HTN",
         "Sedation, dry mouth, autoimmune haemolytic anaemia (Coombs+), hepatotoxicity, impotence",
         "Active hepatic disease, prior methyldopa hepatitis, MAO inhibitors, pheochromocytoma"),
    ]),
    ("Vasodilators", HexColor("#8B5CF6"), [
        ("Hydralazine", "25–100 mg BD-QID oral; 5–20 mg IV/IM",
         "HTN in pregnancy (pre-eclampsia), HFrEF + nitrate, resistant HTN (add-on)",
         "Reflex tachycardia, drug-induced lupus (>200 mg/day), fluid retention, headache, flushing",
         "CAD (reflex tachycardia worsens ischaemia), SLE, mitral valve rheumatic disease"),
        ("Sodium Nitroprusside", "0.3–10 mcg/kg/min IV infusion",
         "Hypertensive EMERGENCY, acute aortic dissection, severe HF (afterload reduction)",
         "Cyanide/thiocyanate toxicity (prolonged use), profound hypotension, reflex tachycardia",
         "Hepatic failure (cyanide accumulation), compensatory HTN, B12 deficiency"),
        ("Minoxidil", "2.5–100 mg OD/BD (reserved – 3rd/4th line)",
         "Resistant HTN (when other agents failed), HTN + severe renal failure",
         "Severe reflex tachycardia, fluid retention/oedema, hirsutism, pericardial effusion",
         "Phaeochromocytoma, acute MI; MUST combine with diuretic + β-blocker"),
    ]),
]

# Comorbidity quick-look table
COMORBIDITY_TABLE = [
    # (condition, preferred, avoid, dose_note)
    ("Post-MI / CAD", "ACEi ✦ ARB ✦ β-blocker",
     "Non-DHP CCBs (depress LV)", "Ramipril 2.5–10 mg/day"),
    ("Heart Failure HFrEF", "ACEi/ARB ✦ β-blocker ✦ MRA ✦ loop diuretic",
     "Non-DHP CCBs ✦ α1-blockers (monotherapy)", "Carvedilol 3.125–25 mg BD"),
    ("Diabetes Mellitus", "ACEi ✦ ARB ✦ CCB ✦ thiazide (low dose)",
     "High-dose thiazide ✦ β-blockers (mask hypoglycaemia)", "Lisinopril 5–40 mg/day"),
    ("CKD / Proteinuria", "ACEi / ARB (1st line) ✦ loop diuretic if GFR <30",
     "Thiazides (GFR <30) ✦ K-sparing + ACEi/ARB combo", "Valsartan 80–320 mg/day"),
    ("Stroke Prevention", "ACEi ✦ ARB ✦ thiazide-like diuretic",
     "Abrupt BP lowering in acute stroke", "Perindopril 4–8 mg + Indapamide 1.25 mg"),
    ("Pregnancy", "Methyldopa ✦ Labetalol ✦ Nifedipine ER ✦ Hydralazine IV",
     "ACEi & ARBs (TERATOGENIC) ✦ Atenolol (IUGR)", "Methyldopa 250–500 mg BD"),
    ("Asthma / COPD", "ACEi/ARB ✦ CCB (amlodipine) ✦ thiazide",
     "β-blockers (bronchospasm)", "Amlodipine 5–10 mg/day"),
    ("HTN Emergency", "IV Labetalol ✦ IV Nicardipine ✦ IV Nitroprusside",
     "Reduce MAP >25% in 1st hour (end-organ ischaemia)", "↓ MAP ≤25% in 1st hr → 160/100 over 2–6 h"),
    ("Atrial Fibrillation", "β-blocker ✦ non-DHP CCBs (diltiazem/verapamil)",
     "DHP CCBs (no rate control) ✦ Digoxin (only sedentary)", "Diltiazem 120–360 mg/day"),
    ("BPH + HTN", "α1-blockers – Doxazosin / Terazosin (dual benefit)",
     "NOT as sole antihypertensive (ALLHAT)", "Doxazosin 1–16 mg/day (start 1 mg)"),
    ("Pheochromocytoma", "Phenoxybenzamine (irreversible α) → then add β-blocker",
     "β-blocker FIRST (unopposed α → crisis!)", "Phenoxybenzamine 10 mg BD, titrate up"),
    ("Resistant HTN", "Add spironolactone as 4th agent; exclude 2° causes",
     "Do NOT combine ACEi + ARB", "Spironolactone 12.5–50 mg/day"),
]

KEY_RULES = [
    ("1st-line preferred", "ACEi/ARB  +  CCB  +  Thiazide  (single-pill combination preferred)", TEAL),
    ("Add β-blocker when", "4th drug in resistant HTN, or: HF / post-MI / AF / angina", CORAL),
    ("NEVER combine", "ACEi + ARB  —  dual RAS blockade → no added benefit, more harm", RED_WARN),
    ("NEVER combine", "β-blocker + non-DHP CCB (verapamil/diltiazem) → complete AV block", RED_WARN),
    ("Pregnancy rule", "Stop ACEi/ARB immediately → methyldopa / labetalol / nifedipine ER", GOLD),
    ("Resistant HTN", "BP above goal on 3 max-dose drugs (incl. diuretic) → add spironolactone", HexColor("#8B5CF6")),
    ("Compliance tip", "Choose agents with t½ allowing once-daily dosing; trough:peak ratio >50%", GREEN),
    ("African Americans", "Thiazides + CCBs more effective; ACEi/ARBs less so as monotherapy", ORANGE),
]

# ── build story ────────────────────────────────────────────────────────────
story = []

def p(text, style=body):
    return Paragraph(text, style)

def colored_tag(text, col, text_col=WHITE, size=7):
    return f'<font color="#{col.hexval()[1:]}" size="{size}"><b> {text} </b></font>'

# ┌─────────────────────────────────────────────────────────────────────────┐
# │  PAGE 1  –  Drug-class blocks, two columns                              │
# └─────────────────────────────────────────────────────────────────────────┘

def make_drug_block(cls_name, cls_color, drugs):
    """Returns a Table acting as a coloured block for one drug class."""
    rows = []
    # class header
    rows.append([
        Paragraph(f'<font color="#FFFFFF"><b>● {cls_name.upper()}</b></font>', hdr1),
        Paragraph('<font color="#FFFFFF"><b>DOSE</b></font>', hdr1),
        Paragraph('<font color="#FFFFFF"><b>COMORBIDITIES</b></font>', hdr1),
        Paragraph('<font color="#FFFFFF"><b>SIDE EFFECTS</b></font>', hdr1),
        Paragraph('<font color="#FFFFFF"><b>CONTRAINDICATIONS</b></font>', hdr1),
    ])
    for i, (drug, dose, comor, se, ci) in enumerate(drugs):
        bg = HexColor("#FFFFFF") if i % 2 == 0 else HexColor("#F0F7FF")
        rows.append([
            Paragraph(f'<b>{drug}</b>', bold7),
            Paragraph(dose, body),
            Paragraph(comor, body),
            Paragraph(se, body),
            Paragraph(f'<font color="#CC0000">{ci}</font>', body),
        ])

    col_w = [32*mm, 33*mm, 46*mm, 48*mm, 46*mm]

    ts = TableStyle([
        ("BACKGROUND",  (0,0), (-1,0), cls_color),
        ("TEXTCOLOR",   (0,0), (-1,0), WHITE),
        ("GRID",        (0,0), (-1,-1), 0.3, HexColor("#CBD5E1")),
        ("ROWBACKGROUNDS", (0,1), (-1,-1), [HexColor("#FFFFFF"), HexColor("#F0F7FF")]),
        ("TOPPADDING",  (0,0), (-1,-1), 2),
        ("BOTTOMPADDING",(0,0),(-1,-1), 2),
        ("LEFTPADDING", (0,0), (-1,-1), 3),
        ("RIGHTPADDING",(0,0), (-1,-1), 3),
        ("FONTSIZE",    (0,0), (-1,0), 8),
        ("FONTNAME",    (0,0), (-1,0), "Helvetica-Bold"),
        ("VALIGN",      (0,0), (-1,-1), "TOP"),
        ("LINEBELOW",   (0,0), (-1,0), 1, cls_color),
    ])

    t = Table(rows, colWidths=col_w, repeatRows=1)
    t.setStyle(ts)
    return t

# Pages 1-3: drug class tables
for cls_name, cls_color, drugs in DRUG_DATA:
    story.append(make_drug_block(cls_name, cls_color, drugs))
    story.append(Spacer(1, 3*mm))

# ── PAGE BREAK → Comorbidity table ────────────────────────────────────────
story.append(PageBreak())

# comorbidity table header
story.append(Spacer(1, 3*mm))
story.append(p("<b>COMORBIDITY-BASED DRUG SELECTION</b>", S("ch",
    fontName="Helvetica-Bold", fontSize=11, textColor=NAVY,
    leading=14, spaceAfter=3)))
story.append(HRFlowable(width="100%", thickness=1.5, color=GOLD, spaceAfter=3))

comor_rows = [[
    Paragraph("<b>Comorbidity</b>", ParagraphStyle("ch", fontName="Helvetica-Bold",
              fontSize=8, textColor=WHITE, leading=10)),
    Paragraph("<b>Preferred Agents</b>", ParagraphStyle("ch", fontName="Helvetica-Bold",
              fontSize=8, textColor=WHITE, leading=10)),
    Paragraph("<b>Avoid / Caution</b>", ParagraphStyle("ch", fontName="Helvetica-Bold",
              fontSize=8, textColor=WHITE, leading=10)),
    Paragraph("<b>Key Dose Note</b>", ParagraphStyle("ch", fontName="Helvetica-Bold",
              fontSize=8, textColor=WHITE, leading=10)),
]]

ROW_COLORS = [
    HexColor("#FFE4E8"), HexColor("#FFF0E4"), HexColor("#E4F9F5"),
    HexColor("#E8F4FD"), HexColor("#F0E8FD"), HexColor("#FFF5E4"),
    HexColor("#E4F9E4"), HexColor("#FFE0E0"), HexColor("#E4F0FF"),
    HexColor("#FFF0FA"), HexColor("#FFE8DC"), HexColor("#E8FAFF"),
]

for idx, (cond, pref, avoid, dose_n) in enumerate(COMORBIDITY_TABLE):
    comor_rows.append([
        Paragraph(f"<b>{cond}</b>",
                  ParagraphStyle("cnd", fontName="Helvetica-Bold", fontSize=7.5,
                                 textColor=NAVY, leading=10)),
        Paragraph(pref,  ParagraphStyle("cp", fontName="Helvetica", fontSize=7,
                         textColor=HexColor("#0D5C3A"), leading=9.5)),
        Paragraph(f'<font color="#CC0000">{avoid}</font>',
                  ParagraphStyle("ca", fontName="Helvetica", fontSize=7,
                                 textColor=RED_WARN, leading=9.5)),
        Paragraph(dose_n, ParagraphStyle("cd", fontName="Helvetica-Oblique", fontSize=7,
                           textColor=HexColor("#1A3A6A"), leading=9.5)),
    ])

ct = Table(comor_rows,
           colWidths=[40*mm, 65*mm, 60*mm, 40*mm],
           repeatRows=1)
ct.setStyle(TableStyle([
    ("BACKGROUND",  (0,0), (-1,0), NAVY),
    ("TEXTCOLOR",   (0,0), (-1,0), WHITE),
    ("GRID",        (0,0), (-1,-1), 0.3, HexColor("#CBD5E1")),
    ("ROWBACKGROUNDS", (0,1), (-1,-1), ROW_COLORS),
    ("TOPPADDING",  (0,0), (-1,-1), 2.5),
    ("BOTTOMPADDING",(0,0),(-1,-1), 2.5),
    ("LEFTPADDING", (0,0), (-1,-1), 3),
    ("RIGHTPADDING",(0,0), (-1,-1), 3),
    ("VALIGN",      (0,0), (-1,-1), "TOP"),
    ("LINEBELOW",   (0,0), (-1,0), 1.5, GOLD),
    ("FONTNAME",    (0,0), (-1,0), "Helvetica-Bold"),
]))
story.append(ct)

# ── PAGE BREAK → Key Rules ────────────────────────────────────────────────
story.append(PageBreak())
story.append(Spacer(1, 3*mm))
story.append(p("<b>KEY PRESCRIBING RULES  &amp;  COMBINATION PRINCIPLES</b>",
               S("krh", fontName="Helvetica-Bold", fontSize=11, textColor=NAVY,
                 leading=14, spaceAfter=3)))
story.append(HRFlowable(width="100%", thickness=1.5, color=CORAL, spaceAfter=5))

rule_rows = []
for label, rule_text, col in KEY_RULES:
    rule_rows.append([
        Paragraph(f'<font color="#FFFFFF"><b>{label}</b></font>',
                  ParagraphStyle("rl", fontName="Helvetica-Bold", fontSize=8,
                                 textColor=WHITE, leading=10, alignment=TA_CENTER)),
        Paragraph(rule_text,
                  ParagraphStyle("rt", fontName="Helvetica", fontSize=8.2,
                                 textColor=DARKTEXT, leading=11)),
    ])

rt = Table(rule_rows, colWidths=[38*mm, 167*mm])
rule_styles = [
    ("GRID", (0,0), (-1,-1), 0.3, MIDGRAY),
    ("VALIGN", (0,0), (-1,-1), "MIDDLE"),
    ("TOPPADDING", (0,0), (-1,-1), 4),
    ("BOTTOMPADDING", (0,0), (-1,-1), 4),
    ("LEFTPADDING", (0,0), (-1,-1), 4),
    ("RIGHTPADDING", (0,0), (-1,-1), 4),
]
for i, (_, _, col) in enumerate(KEY_RULES):
    rule_styles.append(("BACKGROUND", (0,i), (0,i), col))
    row_bg = HexColor("#FFFFFF") if i % 2 == 0 else HexColor("#F8F8FF")
    rule_styles.append(("BACKGROUND", (1,i), (1,i), row_bg))
rt.setStyle(TableStyle(rule_styles))
story.append(rt)

story.append(Spacer(1, 5*mm))
story.append(HRFlowable(width="100%", thickness=1, color=MIDGRAY, spaceAfter=4))

# bp targets mini-table
story.append(p("<b>BLOOD PRESSURE TARGETS (AHA/ACC 2018 vs ESC 2018)</b>",
               S("bpt", fontName="Helvetica-Bold", fontSize=9,
                 textColor=NAVY, leading=11, spaceAfter=3)))

bp_data = [
    [Paragraph("<b>Population</b>",
               ParagraphStyle("bh", fontName="Helvetica-Bold", fontSize=8, textColor=WHITE, leading=10)),
     Paragraph("<b>AHA/ACC Target</b>",
               ParagraphStyle("bh", fontName="Helvetica-Bold", fontSize=8, textColor=WHITE, leading=10)),
     Paragraph("<b>ESC Target</b>",
               ParagraphStyle("bh", fontName="Helvetica-Bold", fontSize=8, textColor=WHITE, leading=10)),
     Paragraph("<b>Definition of HTN</b>",
               ParagraphStyle("bh", fontName="Helvetica-Bold", fontSize=8, textColor=WHITE, leading=10))],
    [p("General adults"), p("<130/80 mmHg"), p("<140/90 mmHg"), p("≥130/80 (USA) / ≥140/90 (EU)")],
    [p("High CVD risk / SPRINT"), p("<120 mmHg systolic"), p("<130/80 mmHg"), p("Intensified target (SPRINT)")],
    [p("Elderly (≥65 yr)"), p("<130 mmHg (SBP)"), p("<140/90 mmHg"), p("Orthostatic hypotension risk")],
    [p("Diabetes mellitus"), p("<130/80 mmHg"), p("<130/80 mmHg"), p("ACEi/ARB preferred")],
    [p("CKD + Proteinuria"), p("<130/80 mmHg"), p("<130/80 mmHg"), p("ACEi/ARB reduce proteinuria")],
    [p("Pregnancy"), p("<160/110 acute; <140/90 chronic"), p("<150/100 mmHg"), p("Methyldopa / Labetalol")],
]
bpt = Table(bp_data, colWidths=[40*mm, 52*mm, 52*mm, 61*mm])
bpt.setStyle(TableStyle([
    ("BACKGROUND", (0,0), (-1,0), NAVY),
    ("TEXTCOLOR", (0,0), (-1,0), WHITE),
    ("GRID", (0,0), (-1,-1), 0.3, MIDGRAY),
    ("ROWBACKGROUNDS", (0,1), (-1,-1), [WHITE, HexColor("#F0F7FF")]),
    ("TOPPADDING", (0,0), (-1,-1), 2.5),
    ("BOTTOMPADDING", (0,0), (-1,-1), 2.5),
    ("LEFTPADDING", (0,0), (-1,-1), 3),
    ("RIGHTPADDING", (0,0), (-1,-1), 3),
    ("FONTSIZE", (0,0), (-1,-1), 7.5),
    ("VALIGN", (0,0), (-1,-1), "TOP"),
    ("LINEBELOW", (0,0), (-1,0), 1.5, GOLD),
]))
story.append(bpt)

# ── BUILD PDF ──────────────────────────────────────────────────────────────
doc = SimpleDocTemplate(
    OUT,
    pagesize=PAGE,
    leftMargin=M, rightMargin=M,
    topMargin=22*mm, bottomMargin=12*mm,
    title="Antihypertensive Drugs – Clinical Pocket Reference",
    author="Clinical Reference Card",
    subject="Antihypertensive pharmacology",
)

doc.build(story, onFirstPage=page_bg, onLaterPages=page_bg)
print(f"PDF written → {OUT}")