Vasodilator Flashcards Preview

T&D III exam 1 > Vasodilator > Flashcards

Flashcards in Vasodilator Deck (59):
1

Calcium channel blockers

Dihydropyridines
Non-dihydropyridines

2

Dihydropyridines

Amlodipine

3

Non-dihydropyridines

Verapamil
Diltiazem

4

CCB

MOA

decrease calcium influx

BV and heart

5

Vascular Effects of CCB

arteriodilation -- dec TPR -- dec BP

6

Which CCB is more potent for vascular effects?

Dihydropyridines

7

Cardiac effects of CCB

Inhibit L-type calcium channels

8

Which phase/where does CCB inhibit

Phase 0 depolarization - SA and AV nodes
Phase 2 of Action Potential - muscle

9

Which CCB is better for cardiac effects?

Verapamil then Diltiazem then Dihydropyridines

10

CCB

best for Vasodilation ?

DHP

11

CCB best overall?

Verapamil

12

ADR

Verapamil

Hypotension
CHF
AV block
Edema
HA
Constipation

13

ADR

DHP

Hypotension
Edema
HA

14

How is ADR for Diltiazem different from Verapamil?

No HA or constipation

15

what's a CI for all CCB?

Severe hepatic dysfunction

16

CI for non-DHP

LV dysfunction

17

What should you avoid with CCB? why?

Short-acting agents
- increases mortality

18

Sick sinus syndrome

Verap
dilt

19

Drug interaction with CCB (more sp Verap)

CYP3A4 inhibitors/inducers
Concurrent beta-blockers
Digoxin
Antiarrhythmic

20

K-channel openers

Moa

inc K+ efflux from vascular SM

21

Example of K-channel opener

Minoxidil

22

What does Minoxidil do

arterial vasodilator -- dec TPR

23

What's significant about Minoxidil?

Marked compensatory responses

- inc HR, inc CO, inc Fluid retention

24

Therapeutic use of Minoxidil

Refractory/malignant hypertension

25

How do you deal with the adverse effects caused by Minoxidil

Loop diuretic - fluid retention
BB - Tachy

26

What can result from marked fluid retention?

Pericardial effusion/cardiac tamponade

27

What's ADR of Minoxidil that is used for therapeutic use?

Hypertrichosis -- Rogaine

28

MOA

Guanylyl Cyclase activators

Activate GC
inc cGMP -- vasodilation

29

Examples of GCA

Nitroprusside
Organic Nitrates
Hydralazine

30

Overall effect of Nitroprusside

dec TPR, CO, BP

inc HR

31

Delivery of nitroprusside

IV

32

Therapeutic use - Nitroprusside

Hypertensive ER
Acute CHF
MI

33

ADR Nitroprusside

Acute hypotension

Chronic thiocyanate/cyanide toxicity

34

How is cynide toxicity avoided with nitroprusside?

Thiosulfate

35

What is the enzyme that converts cyanide and thiosulfate to thiocyanate

Rhodanase

36

Thiocyanate toxicity

weakness
nausea
disorientation
delerium

37

Cyanide toxicity

CN-cytochrome oxidase
cytotoxic anoxia
hypoxia, convulsions, respiratory arrest

38

Example of organic nitrates

Nitroglycerin
Longer acting nitrates

39

Example of longer acting nitrates

Isosorbide Dinitrate/Mononitrate

40

How is organic nitrates different from nitroprusside

organic nit - more venodilation

Nitroprusside - equal veno-/arterio-dilation

41

Dose effect for organic nitrates

low dose - only veno

high dose - both veno and arterio

42

Pharmacokinetics for organic nitrates

Extensive first pass elimination
Sublingual, transdermal, IV

43

Organic nitrates therapeutic use

Angina
CHF

Acute MI

44

ADR - organic nitrates

Excessive hypotension
Tolerance

45

what is the therapeutic use for NO

hypoxic respiratory failure term/near-term neotnates with pulmonary hypertension

46

ADR NO

pulmonary edema
hypoxemia upon sudden withdrawal

47

Therapeutic effect of Hydralazine

CHF

48

Hydralazine ADR

Fluid retention
Tachy

+ANA -- lupus like syndrome

49

Is there reneal involvement with +ANA in Hydralazine?

no

50

D1 receptor agonist

Fenoldopam

51

Use for Fenoldopam

hypertensive emergency

52

PDE-inhibitors

Sildenafil
Tadalafil
Vardenafil

53

which type PDE is inhibited

type 5

54

What does PDE-I do

potentiate effects of NO -- inc cGMP

55

PDE-I -- Smooth muscles in _____ are _____ resulting in increased/decreased __________

Coprpus cavernosum and lower urinary tract

relax

increased erection and urination

56

USE - PDE-I

erectile dysfunction

57

Kinetic - PDE-I

Oral

58

What is Tadafil used for specifically?

BPH

59

Drug interactions - PDE-I

Organic nitrates
alpha-blockers

Cyp3A4 drugs