Vasodilators and Sympatholytics DSA I Flashcards Preview

RENAL II Exam 3 > Vasodilators and Sympatholytics DSA I > Flashcards

Flashcards in Vasodilators and Sympatholytics DSA I Deck (32):
1

vasodilators

relax smooth m of arterioles
-decreased TPR
-symapthetic reflex prevents orthostatic hypotension and sex dysfunction
-vasodilators work best with other anti-hypertensives

2

DHPs

block vascular L-type Ca channels > cardiac

CCB

3

non-DHPs

non-selective block of vascular and cardiac L-type Ca channels

CCB

4

CCBs

smooth m. - vasodilation arterioles > veins
-decreased TPR, afterload, O2 heart demand

cardiac muscle - reduced contractility, slowed SA node pacemaker and AV node conduction velocity**

5

CCB pharmacy

oral admin
-high first pass
-often used IV

6

amlodipine

long half life CCB

7

adverse effects for DHP CCBs

excessive hypotension, dizzy, HA, periphera edema, flushing, tachycardia, rash, gingival hyperplasia

8

adverse effects for non-DHP CCBs

dizzy, HA, peripheral edema, constipation, AV block, bradycardia, heart failure, rash with diltiazem, pulmonary edema, coughing, wheezing

9

short acting nifedipine

studies indicate - increasead risk of MI, stroke, death
-not for chronic HTN

instead use slow-release and long-acting DHPs

10

non-DHP contraindication

beta-blocker use

11

AV conduction

nifedipine does not decrease AV conduction
-therefore, use more safe in AV conduction abnormalities

12

verapamil

may increase digoxin levels

13

clinical use of CCBs

long term therapy for HTN, HTN emergency, angina

14

K channel openers

open K channels in smooth m.
-hyperpolarizes smooth m. membrane
-reducing probability of contraction
-arteriolar dilator - reduced systemic vascular resistance and MAP

15

diazoxide

potassium channel opener
-long acting
-high protein binding
-administered 3-4 injectsions 5-15 min apart

16

potassium channel opener adverse effects

hypotension - stroke and MI
-hypotension greater with renal failure patients, patients with beta-blockers (give small doses)
-hyperglycemia
-avoid ischemic heart disease (likely angina)

17

potassium channel opener use

hypertensive emergency

18

minoxidil

potassium channel opener in smooth m.
-dilation of arterioles, not veins

19

adverse effects of minoxidil

HA, sweating, hypertrichosis (hair growth)

must be used in combo with beta blocker and loop diuretic
-bc of reflex sympathetic stimulation and sodium/fluid retention (angina, edema, palpitations, tachycardia)

20

clinical use of minoxidil

long term outpatient for severe HTN

21

stimulate hair growth

minoxidil - rogaine

22

fenoldopam

dopamine D1 agonist
-peripheral arteriolar dilator and natriuretic
-administered IV (short half life and rapid metabolism)
-avoid in glaucoma patients

23

post-operative HTN

fenoldopam

24

hydralazine

stimulates NO release from endothelium
-increased cGMP
-dilation of arterioles
-high first pass - low bioavailabilty

25

adverse with hydralazine

HA, nausea, anorexia, palpitations, sweating, flushing
-angina or arrhythmia in ischemic heart disease

26

hydralazine clinical use

long term outpatient HTN
-combo with nitrates - heart failure and HTN in blacks

27

HTN in pregnancy Tx

methyldopa and hydralazine

28

sodium nitroprusside

releases NO > increased cGMP
-dilation of arterial and venous vessels
-BP decrease and CO same
IV admin

29

cyanide poisoning

released during metabolism of sodium nitroprusside

30

nitroglycerin

release NO
-relax smooth m of veins > arteries
-no effect on cardiac/skeletal m
-decreased platelet aggregation

high first past - administer sublingual

reached minutes, last 15-30 minutes
-longer duration patches available

31

adverse effects of nitroglycerin

orthostatic hypotension, syncope, throbbing HA

contraindicated - increased intracranial pressure

32

drug-drug nitroglycerin interactions

synergistic hypotension
-wth sildenafil, tadalafil, or vardenafil