CVS (vascular tone)

Question 1

what is the BP for hypertension

Answer 1

140/90

Question 2

what is mioxidil

Answer 2

vasodilator

Question 3

MOA of mioxidil

Answer 3

open K+ channel
= EFFLUX of K+
= hyperpolarisation of SMC
= cannot reach threshold to open Ca2+
= decrease intracellular Ca2+
= cannot bind to calmodulin
= decrease Ca-calmodulin complex
= MLCK cannot be phosphorylated
= no muscle contraction
= vasodilator

Question 4

usage of minoxidil

Answer 4

1. arteriolar dilation
2. sever hypertension

Question 5

ADR of minoxidil

Answer 5

1. reflex SNS stimulation
   = increase HR
   = USE TGT WITH B1 blocker
2. Na and H20 retention

Question 6

what drug classes under inhibitors of angiotensin

Answer 6

1. ACEI
2. AT2 receptor type 1 blockers

Question 7

when are inhibitors of angiotensin given

Answer 7

1. hypertension
2. CF
3. post MI
4. renal insufficiency

Question 8

what are the contraindications of angiotensin inhibitors

Answer 8

pregnancy
= decrease fetal BP
= decrease fetal urination

Question 9

drug names of ACEI

Answer 9

~pril

(eg. captopril)

Question 10

MOA of ACEI

Answer 10

ACEI inhibit conversion of AT1 to AT2

Question 11

effects of AT2

Answer 11

STIMULUS: low BP

1. generalised vasoconstrictor
2. release aldestrone (adrenal glands)
   = increase Na+ and H20 REABSORPTION
   [also increase K+ reabsorption = hyperkalemia]
3. release ADH (hypothalamus)
   = increase H20 REABSORPTION
4. contrict efferent arteriole
   = increase GFR
   = increase Na+ in DCT
5. inhibit bradykinin
   = vasoconstriction
   = increase BP

Question 12

name of AT2 type 1 inhibitors

Answer 12

~sartan

Question 13

MOA of AT2 type 1 inhibitors

Answer 13

competitive inhibitors/ antagonists

Question 14

examples of B blockers

Answer 14

B1:
- atenolol

B1&2:
- propranolol
- timolol

partial agonists
- acebutolol

A and B blockers:
- labetalol

Question 15

MOA of B blockers

Answer 15

block B receptors
= inhibit GPCR
= no ATP –> cAMP conversion

B1:
decrease cAMP
= no phosphokinase A activation
= no Ca2+ influx into cell
= decrease phase 4 depol

B2:
decrease cAMP
= inhibit MLCK
= no MLC phosphorylation
= vasodilation

Question 16

contraindications of B blockers

Answer 16

diabetic patients
= mask symptoms of hypoglycemia

asthma (STILL CAN GIVE, but be careful, due to cross reactivity with B2 = bronchoconstriction)

Question 17

why is B1 blocker preferred for CAD (coronary artery disease)

Answer 17

less side effects

Question 18

do B blockers penetrate the CNS

Answer 18

yes

Question 19

what type of patients are B blockers given to

Answer 19

1. low HR
2. prolonged AV conduction
3. vasodilation
4. HEART FAILURE PATIENTS

Question 20

Ca2+ channel blockers MOA

Answer 20

block Ca2+ ion channel
= decrease intracellular [Ca2+]
=
1. negative chronotropic = lower BP
2. decrease myocardial contracility = lower BP and CO
3. vasodilation = lower BP

Question 21

types of meds for Ca2+ blockers

Answer 21

‘vera danced nicely’
1. vera|pam|il
2. dil|tia|zem
3. ni|fed|i|pine

Question 22

rank the Ca2+ channel blockers

Answer 22

lower BP: V = D = N
vasodilator: N > D > V
prevent cardiac arrhythmias: V > D > N

Question 23

ALL DRUG NAMES

Answer 23

Vasodilators:
minoxidil
ACEI: ~pril
ATII receptor inhibitors: ~sartan
B blockers: ~olol
Ca2+ channel blockers: VDN