Vasodilators & The Treatment Of Angia Pectoris Flashcards Preview

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Flashcards in Vasodilators & The Treatment Of Angia Pectoris Deck (47):
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Nitrates

Nitroglycerin
Isosorbide dinitrate
Isosorbide mononitrate

1

Isosorbide mononitrate

Nitrate: active metabolite of the dinitrate; used orally for prophylaxis

2

Isosorbide dinitrate

Nitrate: very similar to nitroglycerin, slightly longer duration of action

3

Nitroglycerin

Nitrate

4

Nitroglycerin

Mechanism of action

Releases nitric oxide in smooth muscle, whitch activates guanylyl cyclase and increases cGMP

5

Releases nitric oxide in smooth muscle, whitch activates guanylyl cyclase and increases cGMP

Nitroglycerin

Mechanism of action

6

Nitroglycerin

Effects

Smooth muscle relaxation especially in vessels
Other smooth muscle is relaxed but not as markedly
Vasodilation decreases venous return and heart size
May increase flow in some areas and in variant angina

7

Smooth muscle relaxation especially in vessels
Other smooth muscle is relaxed but not as markedly
Vasodilation decreases venous return and heart size
May increase flow in some areas and in variant angina

Nitroglycerin

Effects

8

Nitroglycerin

Clinical applications

Angina: sublingual form for acute episodes
Oral and transdermal forms for prophylaxis
IV form for acute coronary syndrome

9

Angina: sublingual form for acute episodes
Oral and transdermal forms for prophylaxis
IV form for acute coronary syndrome

Nitroglycerin

Clinical applications

10

Nitroglycerin

Toxicity

Orthostatic hypotension, tachcardia, headache

INTERACTIONS: synergistic hypotension with phosphodiesterase type 5 inhibitors (sildenafil, etc)

11

Orthostatic hypotension, tachcardia, headache

INTERACTIONS: synergistic hypotension with phosphodiesterase type 5 inhibitors (sildenafil, etc)

Nitroglycerin

Toxicity

12

Nitrate: very similar to nitroglycerin, slightly longer duration of action

Isosorbide dinitrate

13

Nitrate: active metabolite of the dinitrate; used orally for prophylaxis

Isosorbide mononitrate

14

Beta blockers

Propranolol
Atenolol
Metoprolol

15

Atenolol
Metoprolol

Beta blocker, Beta1-selective blocker, less risk of bronchospam, but still significant

16

Propranolol

Beta blocker

17

Propranolol

Mechanism of action

Nonselective competitive antagonist at Beta adrenoceptors

18

Nonselective competitive antagonist at Beta adrenoceptors

Propranolol

Mechanism of action

19

Propranolol

Effects

Decreased heart rate, cardiac output, and blood pressure
Decreases myocardial oxygen demand

20

Decreased heart rate, cardiac output, and blood pressure
Decreases myocardial oxygen demand

Propranolol

Effects

21

Propranolol

Clinical applications (in angina)

Prophylaxis of angina

22

Prophylaxis of angina

Propranolol

Clinical applications (in angina)

23

Propranolol

Toxicity

Asthma
Atrioventricular block
Acute heart failure
Sedation
INTERACTION: additive with all cardiac depressants

24

Asthma
Atrioventricular block
Acute heart failure
Sedation
INTERACTION: additive with all cardiac depressants

Propranolol

Toxicity

25

Calcium channel blockers

Verapamil
Diltiazem
Nifedipine (dihydropyridine)

26

Verapamil

Calcium channel blocker

27

Diltiazem

Calcium channel blocker

28

Nifedipine

Calcium channel blocker

29

Verapamil
Diltiazem

Mechanism of action

Nonselective block of L-type calcium channels in vessels and heart

30

Nonselective block of L-type calcium channels in vessels and heart

Verapamil
Diltiazem

Mechanism of action

31

Verapamil
Diltiazem

Effects

Reduced vascular resistance, cardiac rate, and cardiac force recult in decreased oxygen demand

32

Reduced vascular resistance, cardiac rate, and cardiac force recult in decreased oxygen demand

Verapamil
Diltiazem

Effects

33

Verapamil
Diltiazem

Clinical applications

Prophylaxis of angina, hypertension, others

34

Prophylaxis of angina, hypertension, others

Verapamil
Diltiazem
Nifedipine

Clinical applications

35

Verapamil
Diltiazem

Toxicity

Atrioventricular block
Acute heart failure
Constipation
Edema
INTERACTIONS: additive with other cardiac depressant and hypotensive drugs

36

Atrioventricular block
Acute heart failure
Constipation
Edema
INTERACTIONS: additive with other cardiac depressant and hypotensive drugs

Verapamil
Diltiazem

Toxicity

37

Nifedipine (dihydropyrdine)

Mechanism of actions

Block of vascular L-type calcium channels > cardiac channels

38

Block of vascular L-type calcium channels > cardiac channels

Nifedipine (dihydropyrdine)

Mechanism of actions

39

Nifedipine (dihydropyrdine)

Effects

Like Verapamil and Diltiazem; less cardiac effect

40

Like Verapamil and Diltiazem; less cardiac effect

Nifedipine (dihydropyrdine)

Effects

41

Nifedipine (dihydropyrdine)

Clinical applications

Prophylaxis of angina, hypertension

42

Prophylaxis of angina, hypertension

Nifedipine (dihydropyrdine)

Clinical applications

43

Nifedipine (dihydropyrdine)

Toxicity

Excessive hypotension
Baroreceptor reflex tachycardia

INTERACTIONS: additive with other vasodilators

44

Excessive hypotension
Baroreceptor reflex tachycardia

INTERACTIONS: additive with other vasodilators

Nifedipine (dihydropyrdine)

Toxicity

45

Like nifedipine but slower onset and longer duration (up to 12 h or longer)

Other dihydropyridines

46

Other dihydropyridines

Like nifedipine but slower onset and longer duration (up to 12 h or longer)