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Pharmacology part 3 > Drugs in peripheral vascular disease > Flashcards

Drugs in peripheral vascular disease Flashcards

1
Q

what can PVD affect?

A

veins or arteries

-common in 65 yr olds

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2
Q

varicose veins

A
  • aching and heaviness
  • Homan’s sign-> calf pain
  • discolored, tortuous, dilated veins visible under surface of skin
  • primary cause of pulmonary emboli
  • valves in veins are working anymore
  • stasis in dilated veins
  • generation of oxidative products
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3
Q

sclerosing agents

A
  • Na tetradecyl sulfate
  • laser therapy
  • protein precipitating agent, new tissue can form
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4
Q

Buerger’s disease

A

thromboangiitis obliterans

  • affects legs mostly
  • inflammation of triangular sheath including femoral artery, vein and nerve
  • claudication (leg cramps on walking), skin ulcers, cold feet and numbness
  • 95% men who smoke
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5
Q

what is recommended for Buerger’s disease

A

exercise, cessation of smoking help and drug of some value

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6
Q

Homan’s sign

A

calf pain on dorsiflexion

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7
Q

primary Raynauds disease

A

mostly affects hands, especially 3 middle fingers

  • 75% patients women
  • excess vasoconstriction in response to cold or emotion
  • ischemic pain then throbbing vasodilation (reddening) which is also painful
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8
Q

Secondary Raynaud’s phenomenon

A

associated with lupus, vibration injury, ect

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9
Q

Perino (chilblains)

A

vascular disorder accompanied by pruritis, a burning sensation and sores of the dorsum of the hands and feet, can also occur on ears

  • associated with cold, damp weather
  • may be chronic with aging
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10
Q

Drugs used in PVD

A
  • block PVD vasoconstriction
  • Ca channel blockers-> do not affect heart, just blood vessels
  • Felodipine, amlodipine
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11
Q

drugs for Raynaud’s, Perino

A
  • Felodipine

- amlodipine

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12
Q

Calcium channel diseases

A

Raynauds
migraine
prinzmetals

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13
Q

alpha-1 blockers in PVD

A

effective for Raynaud’s-> excessive adrenergic activity

  • Prazosin
  • Perino can also respond to alpha-1 blockers
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14
Q

Blood thinner for PVD

A

Pentoxifylline

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15
Q

Pentoxifylline

A

-decreases blood viscosity by decreasing blood protein (mainly fibrinogen)
-takes 2 weeks for onset of effect and for decreased blood viscosity
-also increases RBC deformability
-increased distanced walked before cramps
(works even with atherosclerosis)

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16
Q

side effects of Pentoxifylline

A

GI upset

bleeding (especially with anticoagulants)

17
Q

vasodilator for PVD

A

cilostazol

18
Q

best drug for claudication

A

cilostazol (better than pentoxifylline)

-greater dilation of femoral

19
Q

cilostazol

A

phosphodiesterase 3 inhibitor increases cAMP-> vasodilation

-onset 2-4 weeks

20
Q

best drugs for Buerger’s

A

pentoxifylline

cilastazol

21
Q

best drugs for Raynauds

A

CCB’s
Prazosin
Pentoxifylline

22
Q

best drugs for Perino

A

CCB’s
Prazosin
Pentoxifylline

23
Q

other drugs for PVD but don’t extend life

A

nitrates
diuretics
anticoagulants

24
Q

Drugs NOT FOR PVD

A

sympathomimetics
nicotine
ergot

25
Q

what can reduce morbidity and mortality

A
  • antiplatelets drugs like aspirin
  • ACE-I
  • antilipid drugs
  • Beta-blockers
26
Q

what can PVD progress to?

A

gangrene

  • prognosis related to heart function
  • healing in 15% with good therapy
27
Q

what percent do drugs help for PVD?

A

25%

28
Q

how do vasodilators help with erectile dysfunction?

A

-block phosphodiesterase (PDE5) specific for cGMP in corpus cavernosum
( normally, Ca/calmodulin activates eNOS-> increases NO->cGMP-> vasodilation)

29
Q

selective PDE5 inhibitors

A

sildenafil

taldalafil

30
Q

side effects of PDE5 inhibitors

A

headache
flushing
nasal congestion
myalgia
optic neuropathy with sildenafil (also blocks PDE6) loss blue green, blurring
-may cause extreme decrease BP with nitrates

Pharmacology part 3 (13 decks)

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