Lec 19 Vasodilators and Ca Channel Blockers Flashcards Preview

Cardio Exam 1 > Lec 19 Vasodilators and Ca Channel Blockers > Flashcards

Flashcards in Lec 19 Vasodilators and Ca Channel Blockers Deck (20):
1

What is angina?

chest pain caused by cardiac ischemia

2

What is purpose of pharm management of angina?

reducing myocardial O requirement

3

What type of drugs can you use to treat angina?

vasodilators: nitrates and Ca blockers
cardiac depressants: Beta blockers

4

What is goal of anti-anginal therapy?

reduce myocardial O2 consumption by reducing one or more of the following: end diastolic volume, blood pressure, heart rate, contractility

5

What is mech of action of nitrates?

release NO --> stimulate cGMP --> smooth muscle relaxation --> dilate veins > arteries > arterioles

6

How does smooth muscle relaxation of nitrates decrease myocardial O2 demand?

dilate veins --> decrease preload
dilate arteries --> decrease afterload

7

Do nitrates mostly affect afterload or preload?

preload [b/c dilate veins more than arteries]

8

What is use for nitroprusside?

short acting nitrate
increases cGMP by direct release of NO --> vasodilation

used in hypertensive emergency

9

What other drug should you avoid giving along side nitrate?

phosphodiesterase 5 inhibitor like sildenafil --> cause profound hypotension

10

What are side effects of nitrates?

- reflex tachycardia
- orthostatic hypotension
- headache from vasodilation of meningeal artery
- tolerance

11

Which drug should you worry about cyanide poisoning?

long term use nitroprusside = metabolized to cyanide

12

What are the 2 dihydropyridines?

Ca blockers:
nifedipine
amlodipine

13

What are the 2 non-dihydropyridines?

Ca blockers:
dilitiazem
verapamil

14

What is order of activity in vascular smooth muscle:
diltiazem
verapamil
amlodipine
nifedipine

amlopidine = nifedipine > diltiazem > verapamil

15

What is order of activity in cardiac smooth muscle:
diltiazem
verapamil
amlodipine
nifedipine

verapamil > diltiazem > amlodipine = nifedipine

16

Which Ca channel blockers can have reflex tachycardia?

nifedipine

17

What is main action of dihydropyridines?

nifedipine/amlodipine/nimodipine

mostly dilates arteries --> decrease afterload

18

What is main action of non-dihydropyridines?

dilitiazem/verapamil

mostly decrease cardiac contractility + decrease HR [by acting on AV/SA node]

19

Which Ca channel blockers might not be a good idea in pt with CHF/bradycardia?

non-dihydropyridines = diltiazem + verapamil

20

What are side effects of Ca channel blockers?

- cardiac depression
- peripheral edema
- flushing
- dizziness
- hyperprolactinemia
- constipation