Flashcards in Intro to Antihypertensive Agents IV Deck (51)
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1
amlodipine
calcium channel blocker
2
clevidipine
calcium channel blocker
-DHP
3
felodipine
calcium channel blocker
-DHP
4
isradipidine
calcium channel blocker
-DHP
5
nicardipine
calcium channel blocker
-DHP
6
nifedipine
calcium channel blocker
-DHP
7
nisoldipine
calcium channel blocker
-DHP
8
diltiazem
calcium channel blocker
-non-DHP
9
verapamil
calcium channel blocker
-non-DHP
10
diazoxide
K channel opener
11
minoxidil
K channel opener
12
fenoldopam
dopamine agonist
13
hydralaine
NO donor
14
nitroprusside
NO donor
-nitropress
15
nitroglycerin
NO donor
-organic nitrate
16
isosorbide dinitrate
NO donor
-organic nitrate
17
calcium channel blocker mechanism
block L-type Ca channels
-cardiac myocyte and SA and AV nodal cells
decreased vascular smooth m contraction
18
dihydropyridine mechanism
-bind L-type Ca channels
-arteriolar vasodilation predominant
**more vascular effect
19
non-dihydropyridine mechanism
-bind L-type Ca channels
-predominant cardiac effects, but also act at vascular tissues
verapamil > diltiazem
20
hemodynamics of CCBs
-reduced TPR
-reduced afterload
-reduced O2 demand
-non-DHPs reduce CO
-decreased coronary vascular resistance and increased coronary blood flow
21
CCBs and cardiac muscle
negative inotropic effect
-Na fast channel primary depolarization, but Ca slow channels is additional
-Ca entry - induce Ca release from SR
-Ca binds troponin - allows contraction
verapamil > diltiazem > DHPs (inotropic effects)
22
DHPs
relax vascular smooth m at lower concentration than required for direct action on heart
23
DHPs and cardiac muscle
greater vasodilatory effect
-reflex increased sympathetic tone that overcomes negative inotropic effect
24
CCB effect on cardiac nodal cells
SA and AV node - depolarization L-type Ca channels
DHPs block channel - but don't effect recovery of channel and ARE NOT frequency dependent
25
verapamil and diltiazem
non-DHP CCB
-block channel, delay recovery of channel, and ARE frequency dependent
-decreased rate of SA node depolarization and slow AV nodal conduction
-useful for Tx of supraventricular tachyarrhythmias but dangerous for patients with slow nodal conduction
26
non-DHPs
more cardiac effect
-decreased contractility, suppress SA automaticity, and AV conduction
27
CCB pharmacokinetics
high 1st pass effect
28
long half life CCBs
amlodipine, felodipine, isradipine
29
DHP with long plasma half lives **
preferred to minimize reflex cardiac effects
-**decreased reflex tachycardia
-release preparations are available
30
