Direct acting vasodilators for systemic arterial hypertension Flashcards
What is the mechanism of action for the drug Hydralazine?
This drug acts to induce IP3 related calcium release decreasing arterial contraction.
This relaxes only the arterioles not the veins!
When is Hydralazine typically used
Most commonly used as an add on drug in resistant hypertension.
It is safe in gestational pregnancy
Which antihypertensive medication is safe to use during pregnancy!?
Hydralazine!
What are the side effects of Hydralazine?
Drug induced lupus after longterm use.
Compensatory tachycardia and sodium retention.
When used for chronic hypertension, hydralazine should be used in combination with….
A diuretic and a beta blocker or Non-DHP CCB to mitigate drug induced lupus and compensatory tachycardia!
What is the MoA of the drug Minoxidil?
This drug acts as a Katp opener allowing arterioles to relax with no effect on the veins.
What are the cardiovascular effects of the drug minoxidil?
Minoxidil acts to decreas BP.
It also increases blood flow to the heart, skin (rogaine), skeletal muscle, GI and CNS.
Increases CO
And increases renal blood flow.
What type of hypertension should Minoxidil be used for?
Should be used in the treatment of severe refractory hypertension in combination with Beta blockers or antidiuretics.
What is the MoA of the drug nitroprusside?
This drug donates NO to the cGMP Ca2+ smooth muscle causing vasodilation with rapid onset and short duration.
What effect does nitroprusside have on the heart?
Decreases both preload and after load through NO mediated dilation.
What are the side effects of nitroprusside?
May cause methemglobia
Cyanide poisoning
and cell death (cyanide)
What role does thiazides have in the treatment of heart failure?
First line or add on for uncomplicated HTN
Dirst line for left ventricular dysfunction and previous ischemic stroke.
What are intersting systemic problems that can be treated with NDHP CCB?
Reynauds
Migraine
arrhythmias
high normal HR or tachycardia
