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Pharmacology > Lecture 18: Vasodilators > Flashcards

Lecture 18: Vasodilators Flashcards

1
Q

Describe polyphosphoinositide signaling

A
  1. Gq activates membrane phospholipase C
  2. Hydrolyzes IP3/DAG
  3. IP3 releases Ca2+
  4. DAG stimulates PKC- IP3 dephosphorylated, DAG broken down and Ca2+ pumped out
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2
Q

What vasodilators increase cGMP and cause relaxation of vascular smooth muscle

A

NO, nitrprusside, organic nitrates, and PDE V inhibitors

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3
Q

What vasodilators decrease intracellular ca2+ and therefore relax vascular smooth muscle

A

CCB’s

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4
Q

CAMP increases the inactivation of ___kinase

A

Myosin light chain kinase

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5
Q

In order to promote relaxation what must happen to myosin light chain

A

Dephosphorylate

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6
Q

Vasodilators further improve ___ and reduce __ and ___ in heart failure patients

A

Cardiac output, edema and effusions

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7
Q

Vasodilators that reduce arteriolar resistance are also used in treatment of ___

A

Hypertension

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8
Q

How do ACE inhibitors effect vasodilation veins and arteries

A

arteries: +
Veins: +

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9
Q

How do nitrites effect vasodilation of veins and arteries

A

Arteries: +
Veins: ++

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10
Q

How does hydralazine effect vasodilation of arteries and veins

A

Arteries: +
Veins: -

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11
Q

How do CCB’s effect vasodilation of arteries and veins

A

Arteries: ++
Veins: -

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12
Q

How do alpha blockers effect vasodilation of arteries and veins

A

Arteries: +
Veins: +

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13
Q

What species is hydralazine commonly used in

A

Dogs, cats and rarely horses

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14
Q

Hydralazine dilates __ but not ___

A

Arteries but not veins

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15
Q

What is hydralazine most effective in treating

A

HF secondary to mitral valve insufficiency

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16
Q

Nitrates preferentially dilate ___ however dilate __ too

A

Veins, arteries

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17
Q

What vasodilators act through nitric oxide

A
  1. Hydralazine
  2. Nitrates
    - nitroglycerin
    - isosorbide dinitrate
    - sodium nitroprusside
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18
Q

What is nitroglycerin used for

A

Pulmonary edema associated with HF

**vasodilate veins over arteries so assists with Left side HF symptoms

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19
Q

T or F: tolerance may develop with use of nitroglycerin

A

True

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20
Q

T or F: isosorbide dinitrate may develop tolerance

A

True

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21
Q

Which nitrate is a potent vasodilator that is administered as a constant infusion

A

Sodium nitroprusside

22
Q

With the use of sodium nitroprusside, ___ toxicity may develop in patients with compromised renal function

A

Cyanide

23
Q

T or F: tolerance develops with the use of sodium nitroprusside

A

False

24
Q

When is sodium nitroprusside used

A

Pulmonary edema associated with HF and emergent hypertensive crisis

25
Q

What are the two important functions of Ca2+

A
  1. Trigger muscle contractions in myocardium and vascular smooth muscle
    2, required for pacemaker activity of SA node and conduction through AV node
26
Q

How are vascular smooth muscle and heart calcium channels opened in the heart

A

B-adrenergic stimulation

27
Q

How are heart and vascular smooth muscle calcium channels closed

A

CCB’s inhibit calcium entry

28
Q

what channels do CCB’s act on

A

L-type channels

29
Q

What do CCB’s do to transmembrane calcium current

A

Decrease

30
Q

CCB’s cause a long lasting __ of vascular smooth muscle

A

Relaxation

31
Q

How do CCB’s effect cardiac contractility, automaticity and conduction

A

Decrease

32
Q

CCB’s will relax all smooth muscles that depend on calcium. ___ muscle is most sensitive but __, __, and __ is also relaxed

A

Vascular smooth muscle, but bronchiolar, gastrointestinal and uterine

33
Q

CCB’s preferentially dilate ___ over __

A

Arterioles, veins

34
Q

What are the major cardiac effects of CCB’s

A
  1. Negative inotropic effect due to decreased contractility
  2. Reduced impulse generation from SA node
  3. Slowed AV node conduction
35
Q

What type of drug is amlodipine besylate

A

Long acting CCB

36
Q

What does amlodipine besylate do

A

Vasodilate

37
Q

Amlodipine besylate is the drug of choice for __

A

Hypertensive cats

38
Q

The use of amlodipine is cautioned when __ function is poor

A

Liver

39
Q

Amlodipine besylate can activate RAAS but this is reduced if concurrently used with

A

Enalapril (ACEi)

40
Q

What type of drug is diltiazem

A

CCB

41
Q

What does diltiazem do

A

Depresses AV and SA node for cardiac contractile depression

42
Q

When is diltiazem used

A

HCM in cats and supraventricular tachycardia in dogs and cats

43
Q

Which has a greater vasodilatory effect and causes reflex tachycardia: amlodipine or diltiazem

A

Amlodipine

44
Q

Which has a greater depression of SA and AV node, and negative inotropic effect: amlodipine or diltiazem

A

Diltiazem

45
Q

What type of drug is sildenafil

A

Selective inhibitor of cGMP specific PDE5

46
Q

How does sidenafil work

A

By decreasing elimination of cGMP produces vasodilation

47
Q

Sidenafil seems to be effective in ___ in dogs

A

Pulmonary hypertension

48
Q

What type or drug is prazosin

A

Alpha1 adrenergic antagonist

49
Q

When is prazosin used

A
  1. Typically for functional urethrospasm in dogs
  2. HF less characterized but can be considered when hydralazine is poorly tolerated
50
Q

How does prazosin work

A

Blocks alpha1 adrenergic receptors so opposes NE vasoconstriction and dilates both arteries and veins

BP decreases

51
Q

Prazosin can cause reflex __

A

Tachycardia

52
Q

What are some adverse effects of prazosin

A

Hypotension, Na+ and H20 retention

Pharmacology (14 decks)

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