4.14 pharm MI Flashcards
(16 cards)
3 side effects of organic nitrates
Headache
Orthostatic hypotension
Methemoglobinemia
Mechanism of organic nitrates
Vascular smooth muscle relaxation
(S nitrosothiols and NO stimulate guanylate cyclase, producing cGMP, which inhibit Ca entry, causing smooth m relaxation)
-afil impotence drugs have an interaction with
Organic nitrates
What are the organic nitrates
Nitroglycerin
Amyl nitrite
Isosorbide mono/di nitrate
2 tolerance mechanisms of organic nitrates
Deplete cysteine and SH groups
Down regulate ADH activity
What enzyme makes NO
Aldehyde dehydrogenase
S nitrosothiols are made from
Cysteine
Inhaled organic nitrate
Amyl nitrite
Long acting organic nitrate
Isosorbide mono/di nitrate
Mechanism of ranolazine
Blocks late Na channels (causes less Na in) so less Ca entry via NCX
Used for chronic angina patients not responsive to other anti-angina drugs
Ranolazine
Ranolazine is used in conjunction with which meds
Beta blocker
Ca channel blocker
Organic nitrates
Why is it beneficial to have beta blockers and organic nitrate combo
Nitrates usually have baroreceptor response
Beta blockers usually moves patient toward CHF
Combo prevents both from happening
What calcium channel blocker has additive effects with beta blockers
Diltiazem
What can be combined safely with beta blockers (>1 answer)
Nifedipine
Nicarpine
Nisoldipine
What calcium channel blocker is combined with nitrates to offset risk of congestion
Verapamil
Bepridil
