Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm 2 > Class 4 Deck 1 > Flashcards

Class 4 Deck 1 Flashcards

1
Q

Name the 3 sites of actions in which a vasodilator can be classified.

A
  • Arterial dialator (resistance circulation)
  • Venodialators (Capacitance circulation)
  • Balanced
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Give and example of an Arterial dialator, venodialator, and a balanced vasodialator.

A
  • Arterial = Hydralizine, ACE, Nicardipine
  • Balanced = Nitroprusside
  • Venodialator = Nitroglycerine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pure arteriole dilator causes minimal effect on what?

A

-Preload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Balanced vasodilator (SNP) decreases what 2 things?

A

-Afterload and preload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What drug may be the only pure pulmonary vasodilator?

A

-Nitrous Oxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

PGE1 is excellent pulmonary vasodilator, but also causes systemic?

A

Hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What drug may improve coronary circulation?

A

-NTG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which drug will increase coronary perfusion pressure?

A

-Nitroglycerine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

In presence of coronary steal, what drug will shunt blood away from ischemic areas and what drug will direct more blood to the ischemic area?

A
  • SNP is bad during MI

- Nitroglycerine is good during MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does nitroglycerine treat myocardial ischemia?

A
  • Coronary vasodialtor / Improved collateral flow

- Venodialation decrease venous return and filing pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does CCB treat myocardial ischemia?

A
  • coronary and systemic vasodialators
  • Decrease afterload
  • Treats coronary vasospasm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why is SNP non-useful with myocardial ischemia?

A
  • Reduces ventricular filling pressure

- Coronary steal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What 2 drugs use NO, in order to produce their effects? and how do they work?

A
  • SNP (spontaneously generates NO)

- NTG (Requires a cofactor to release NO in smooth muscle)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How does NO (therefore SNP and NTG) produce vasodialation?

A
  • Forms cGMP

- cGMP inhibits calcium entry into smooth muscle cells, which produces vasodialation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the effects of NO?

A
  • Vasodilator
  • Relax other smooth muscle
  • Increase blood flow to the lung
  • Decreases pulmonary vascular resistance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the clinical applications of NO?

A
  • Hypoxic respiratory failure
  • Pulmonary artery HTN
  • CPR
17
Q

What are the adverse effects of NO?

A
  • Reacts w/ O2 to form nitrogen dioxide
  • Pulmonary irritant can decrease lung function
  • Can induce methemoglobinemia (hemoglobin that doesn’t bind to w/ O2)
18
Q

What type of drug will prolong the effects of NO?

A

-phosphodiesterase (PDE) viagra & cialis

19
Q

What are the effects of SNP?

A
  • Direct action on vascular smooth muscle
  • Decrease MAP
  • Decrease LA and LV filling pressure
  • Decreased afterload promotes forward flow in MR & AI
  • Coronary steal
20
Q

What are the adverse effects of SNP?

A
  • Increase cerebral blood flow and ICP
  • Reflex tach and HTN w/ abrupt discontinuation
  • Decreased renal blood flow
  • Hypotensive efffects w/ spinal or GA
  • Worsen intrpulmonary shunt
21
Q

SNP usage guidelines?

A
  • A-Line
  • Can use peripheral line
  • Mix in D5W
  • Protect from light (breakdown to cyanide)
22
Q

What are the advantages of SNP?

A
  • Immediate onset
  • Short duration
  • reduced myocardial O2 demand
23
Q

Disadvantages of SNP

A
  • Reflex Tach
  • Cyanide toxicity ***(photodegredation)
  • intrapulmonary shunt
  • Methemoglobinemia***
  • coronary steal
  • Bleeding
  • cerebral vasodilator
24
Q

What is the hyperdynamic response sometime seen with SNP? and how do you treat it?

A
  • Widening of pulse pressure
  • Increase GR
  • Treat w/ Beta Blocker
25
Q

Tacyphylaxis in SNP can be a sign of what?

A

-Cyanide toxicty

26
Q

How to treat cyanide toxicity?

A
  • Stop SNP
  • 100% O2
  • Correct acidosis w/ bicarb
  • 3% sodium nitrate (oxyhemo to methemo)
  • Sodium thiosulfate
  • hydroxycobalamin (binds to cyanide)
27
Q

Thiocynate toxicity tidbits

A
  • Rare
  • Cleared by kidneys
  • Neurotoxicity
  • inhibit uptake of iodine (hypothyroidism possible)
28
Q

Nitroglycerin (NTG) effects

A
  • Releases NO through a cofactor
  • Smooth muscle relaxation
  • Affects preload more than afterload
  • Dilates vein more than arteries
29
Q

What does NTG do to Cardiac vasculature?

A
  • relaxes coronary vessels
  • Dilates collateral circulation
  • Reduces preload and wall tension = ↓ myocardial O2 consumption
  • Increased endocardial flow over epicardial flow

Pharm 2 (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions