Lecture 22 - Vasodilators Flashcards Preview

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Flashcards in Lecture 22 - Vasodilators Deck (51):
1

What are the families of drugs used for vasodilation purposes?

NO acting
Calcium Channel Antagonists
PDE5 inhibitors
Alpha 1 Adrenergic antagonists

2

Drugs within Family: NO acting

Hydralazine
Nitrate

3

Drugs within Family: Nitrate

Nitroglycerin
Isosorbide dinitrate
Sodium Nitroprusside

4

Drugs within Family: Calcium channel antagonists

Amlodipine besylate
Diltiazem

5

Drugs within Family: PDE5 inhibitors

Sildenafil

6

Drugs within Family: Alpha-1 aderenergic antagonists

Prazosin

7

What does Gq cause to occur?

Activates PLC

8

After PLC is activated by Gq what are the downstream effects?

PIP2 --> DAG + IP3
IP3 - dephosphorylated
DAG - broken down
Ca - pumped out

9

What does DAG go and do once activated?

Stimulate PKC

10

What does IP3 do and do once it is activated?

Release Ca from intracellular storage

11

What are three ways that one can relax vascular smooth muscle?

Increase cGMP
decrease intracellular Ca
Increase cAMP in vascular cells

12

What drugs can increase cGMP?

NO
Nitroprusside
Organic nitrates
PDE 5 inhibitors

13

What drugs can decrease intracellular Ca?

Calcium channel blcokers

14

Why is it preferred to have increased cAMP within the vascular cells?

cAMP = inactivation of myosin light chain kinase

15

Term: Phosphatase

Dephosphorylates MLC

16

Term: MLCK

Prevents phosphorylation

17

What can vasodilators do that help some heart failure patients?

Improve CO
-- and --
Reduce edema + Effusion

18

What can drugs that reduce arterolar resistance be used for commonly?

Pulmonary hypertension

19

What drugs can effect the walls of arteries and/or veins?

ACEi
Nitrites
Hydralazine
CCA-s
Alpha-blockers

20

Vessels affected: ACEi

A = V

21

Vessels affected: Nitrates

A

22

Vessels affected: Hydralazine

A

23

Vessels affected: CCA's

A a lot

24

Vessels affected: Alpha-blockers

A = V

25

What is hydralazine commonly used for?

Mitral valve insufficency

26

What happens with hyralazine toxicity?

Vomiting + Anorexia + Tachycarida + Sweating +
Ischemic arrhythmia + Decomposition

27

What hydralazine side effect is seen in all animals besides dogs?

Hypotension

28

What do Nitrate compounds do chemically?

NO donors

29

What do nitrates do within the cell?

Decrease the phosphorylation of light chain mysosin

30

What is nitroglycerin used for?

Pulmonary edema with CHF

31

How is nitroglycerin administered?

Topically

32

How is isosorbide dinitrate administered?

Oral

33

How is sodium nitroprusside administered/

Constant IV

34

What is sodium nitroprusside used for?

Pulmonary edema
-- and --
Emergent hypertensive crisis

35

What are the two important functions of intracellular calcium?

Triggers muscular contraction
-- and --
Pacemake activity

36

Smooth muscle calcium channels are open to:

B-Adrenergic stimulation

37

Smooth muscle calcium channels are closed to:

CCA's

38

How do CCA's work?

Orally active
Bind to L-type Ca channels in myocardium vascular SM

39

What three things will CCA's cause?

Decrease transmembrane Ca current
Long-lasting relaxation
Decreased cardiac contractility + automaticity + conduction

40

What other smooth muscle is affected by CCA's

Bronchiolar + Gastrointestinal + Urterine

41

What are the major cardiac affects of CCA's?

Negative inotropic effect
Reduced impulse generation
Slowed AV

42

Characteristics of amlodipine besylate:

Long lasting
Ca channel blocker
Vasodilation without cardiac effects

43

What is Amlodipine besylate used for?

Hypertension in cats

44

What is diltiazem used for?

Hypertrophic cardiomyopathy
-- and --
Supraventricular tachycardia

45

What is different about the metabolism of Diltiazem?

Two active metabolites once it is processed by the liver

46

What needs to be taken into consideration when giving a patient Diltiazem?

Can be passed through milk

47

How does sildenafil work?

Decreases the elimination of cGMP = vasodilation

48

When is sildenafil used?

Pulmonary hypertension in dogs

49

What is the primary use of prazosin?

Urtheral obtruction in dogs

50

How does prazosin work?

Reduces NE vasocontriction

51

What are the adverse effects of prazosin?

Hypotension
Na + Water retension