Lecture 22 - Vasodilators

Question 1

What are the families of drugs used for vasodilation purposes?

Answer 1

NO acting
Calcium Channel Antagonists
PDE5 inhibitors
Alpha 1 Adrenergic antagonists

Question 2

Drugs within Family: NO acting

Answer 2

Hydralazine

Nitrate

Question 3

Drugs within Family: Nitrate

Answer 3

Nitroglycerin
Isosorbide dinitrate
Sodium Nitroprusside

Question 4

Drugs within Family: Calcium channel antagonists

Answer 4

Amlodipine besylate

Diltiazem

Question 5

Drugs within Family: PDE5 inhibitors

Answer 5

Sildenafil

Question 6

Drugs within Family: Alpha-1 aderenergic antagonists

Answer 6

Prazosin

Question 7

What does Gq cause to occur?

Answer 7

Activates PLC

Question 8

After PLC is activated by Gq what are the downstream effects?

Answer 8

PIP2 –> DAG + IP3
IP3 - dephosphorylated
DAG - broken down
Ca - pumped out

Question 9

What does DAG go and do once activated?

Answer 9

Stimulate PKC

Question 10

What does IP3 do and do once it is activated?

Answer 10

Release Ca from intracellular storage

Question 11

What are three ways that one can relax vascular smooth muscle?

Answer 11

Increase cGMP
decrease intracellular Ca
Increase cAMP in vascular cells

Question 12

What drugs can increase cGMP?

Answer 12

NO
Nitroprusside
Organic nitrates
PDE 5 inhibitors

Question 13

What drugs can decrease intracellular Ca?

Answer 13

Calcium channel blcokers

Question 14

Why is it preferred to have increased cAMP within the vascular cells?

Answer 14

cAMP = inactivation of myosin light chain kinase

Question 15

Term: Phosphatase

Answer 15

Dephosphorylates MLC

Question 16

Term: MLCK

Answer 16

Prevents phosphorylation

Question 17

What can vasodilators do that help some heart failure patients?

Answer 17

Improve CO
– and –
Reduce edema + Effusion

Question 18

What can drugs that reduce arterolar resistance be used for commonly?

Answer 18

Pulmonary hypertension

Question 19

What drugs can effect the walls of arteries and/or veins?

Answer 19

ACEi 
Nitrites 
Hydralazine 
CCA-s 
Alpha-blockers

Question 20

Vessels affected: ACEi

Answer 20

A = V

Question 21

Vessels affected: Nitrates

Answer 21

A

Question 22

Vessels affected: Hydralazine

Answer 22

A

Question 23

Vessels affected: CCA’s

Answer 23

A a lot

Question 24

Vessels affected: Alpha-blockers

Answer 24

A = V

Question 25

What is hydralazine commonly used for?

Answer 25

Mitral valve insufficency

Question 26

What happens with hyralazine toxicity?

Answer 26

Vomiting + Anorexia + Tachycarida + Sweating + | Ischemic arrhythmia + Decomposition

Question 27

What hydralazine side effect is seen in all animals besides dogs?

Answer 27

Hypotension

Question 28

What do Nitrate compounds do chemically?

Answer 28

NO donors

Question 29

What do nitrates do within the cell?

Answer 29

Decrease the phosphorylation of light chain mysosin

Question 30

What is nitroglycerin used for?

Answer 30

Pulmonary edema with CHF

Question 31

How is nitroglycerin administered?

Answer 31

Topically

Question 32

How is isosorbide dinitrate administered?

Answer 32

Oral

Question 33

How is sodium nitroprusside administered/

Answer 33

Constant IV

Question 34

What is sodium nitroprusside used for?

Answer 34

Pulmonary edema -- and -- Emergent hypertensive crisis

Question 35

What are the two important functions of intracellular calcium?

Answer 35

Triggers muscular contraction -- and -- Pacemake activity

Question 36

Smooth muscle calcium channels are open to:

Answer 36

B-Adrenergic stimulation

Question 37

Smooth muscle calcium channels are closed to:

Answer 37

CCA's

Question 38

How do CCA's work?

Answer 38

Orally active | Bind to L-type Ca channels in myocardium vascular SM

Question 39

What three things will CCA's cause?

Answer 39

Decrease transmembrane Ca current Long-lasting relaxation Decreased cardiac contractility + automaticity + conduction

Question 40

What other smooth muscle is affected by CCA's

Answer 40

Bronchiolar + Gastrointestinal + Urterine

Question 41

What are the major cardiac affects of CCA's?

Answer 41

Negative inotropic effect Reduced impulse generation Slowed AV

Question 42

Characteristics of amlodipine besylate:

Answer 42

Long lasting Ca channel blocker Vasodilation without cardiac effects

Question 43

What is Amlodipine besylate used for?

Answer 43

Hypertension in cats

Question 44

What is diltiazem used for?

Answer 44

Hypertrophic cardiomyopathy -- and -- Supraventricular tachycardia

Question 45

What is different about the metabolism of Diltiazem?

Answer 45

Two active metabolites once it is processed by the liver

Question 46

What needs to be taken into consideration when giving a patient Diltiazem?

Answer 46

Can be passed through milk

Question 47

How does sildenafil work?

Answer 47

Decreases the elimination of cGMP = vasodilation

Question 48

When is sildenafil used?

Answer 48

Pulmonary hypertension in dogs

Question 49

What is the primary use of prazosin?

Answer 49

Urtheral obtruction in dogs

Question 50

How does prazosin work?

Answer 50

Reduces NE vasocontriction

Question 51

What are the adverse effects of prazosin?

Answer 51

Hypotension | Na + Water retension