Last lecture for Exam 2

Question 1

Does nitroprusside (SNP) only work on arteries or veins or both

Answer 1

BOth

Question 2

Differentiate structure of hydralazine from Organic nitrates

Question 3

Does hydralazine dilate arteries or veins or both

Answer 3

Artery

Question 4

MOA of hydralazine

Answer 4

Interferes with Ca release from ER and orevents oxidation of NO

Question 5

Why is hydralazine and ISDN used together? WHat os the drug called?

Answer 5

Hydralazine stops the oxidation of NO, this potentiates the vasodilatory effect of ISDN

BilDil is drugs name (useful in african american)

Question 6

T/F organic nitrates stimulate guanylyl cyclase

Answer 6

True

Question 7

What are the two drugs that have MOA related to Type B natriuretic peptide (BNP

Answer 7

Natrecor
Sacubitril

Question 8

differentiate between Natrecor and Sacubitril

Answer 8

Natrecor is the synthetic version of BNP.
It binds to and activates membrane bound guanylyl cyclase

Sacubitril prevents the breakdown of BNP and enhances its action by inhibiting the protease that breaks down BNP (bneprilysin)

Question 9

Can sacubitril be used with ACE? ARB? WHY?

Answer 9

ARB yes, not ACE

Not ACE because both elevated bradykinin

Question 10

Know name and structure of PDE inhibitors

Question 11

Is PDE3 more selective to cAMP or cGMP

Answer 11

cAMP

Question 12

Name PDE3 drugs

Answer 12

Amrinone
Milrinone (has an extra carbon)

Question 13

Is PDE5 cAMP or CGMP

Answer 13

CGMP

Question 14

Name CGMP (PDE5) drugs

Answer 14

Sildenafil
Dipyridamole

Question 15

Where are PDE3 most commonly found in

Answer 15

Vascular Smooth muscle

Question 16

PDE 3 drug names and MOA

Answer 16

Amrinone and Milrinone

-They inhibit PDE 3s breakdown of cAMP to AMP
-lead to cAMP elevation
-Elevation of cAMP causes vasodilation

Question 17

How does elevation of cAMP cause vasodilation

Answer 17

It inhibits myosin LC K, inducing relaxation

Question 18

What is sildenafil selective for

Answer 18

PDE5

Question 19

Why does sildenafil cause a little blueish vision

Answer 19

Some PDE6 activity

Question 20

What are PDE5 drugs usually used for? Why?

Answer 20

Erectile dysfunction. This is due to the fact that PDE4 is predominant is corpus cavernosum

Question 21

3 major PDE 5 inhibitors

Answer 21

Sildenafil (ciagra)
Vardenafil (levitra)
Tadalafil(cialis

Question 22

Structural difference between Sildenafil and Vardenafil

Answer 22

Sildenafil has jude bellingham O=S=O with 1 carbon on para N

C=Vardenafil has jude ellingham O=S=O with 2 carbons on para N

Question 23

longest duration of action for PDE5 inhibitors

Answer 23

Cialis

Question 24

What is contraindicated with PDE5

Answer 24

any organic nitrates

Question 25

Which adrenoreceptor regulates vasoconstriction

Answer 25

A-1 adrenergic receptor

Question 26

what drugs are used chronic orthostatic hypotension

Answer 26

Droxidopa
Midodrine

Question 27

use of epinephrine with local anesthetic

Answer 27

-elongates the duration of anesthetic due to reduction of bloodflow to area
-reduced toxicity
reduced dose required

Question 28

What are some direct and indirect vasoconstrictors used for nasal and opthalmic decongestion

Answer 28

direct- phenylephrine
indirect- sudafed

Question 29

name 4 things that can increase HTN

Answer 29

NSAIDS, steroids, caffeine, nicotine

Question 30

for HTN below 120/80 tx, follow up?

Answer 30

normal. Reassess in 1 year

Question 31

tx For htn 120-129 /<80
follow uo

Answer 31

elevated, non pcol
follow up in 3-6 months

Question 32

Tx for 130-139/80-89
Follow up

Answer 32

If ASCVD risk>or=10 nonpcol, pcol and reassess in 1 month

if ASCVD risk<10, non pcol, reassess in 3-6 months

even if ASCVD risk is <10, but patient has DM, CKD, HF or ischemic heart disease, use pcol

Question 33

If 140/90 tx
follow up

Answer 33

Pcol + 2 meds—> reassess in 1 month

Question 34

non pcol recommendations for HTN

Answer 34

Weight loss
DASH diet
reduced salt (<1500mg)
Increased K intake
physical resistance
Moderate alc

Question 35

DASH diet

Answer 35

Dietary approach to reduce HTN