module 7 vasodilators and digoxin Flashcards

1
Q

hydralazine mechanism of action and use

A
vasodilator
stimulates NO production in endothelial cells
-> arterial dilation 
Uses: 
- HTN
- HF
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2
Q

hydralazine adverse effects

A

fluid retention
reflex tachycardia
drug fever
peripheral neuropathy
rare: reversible systemic lupus like syndrome
tachyphylaxis (less effect over time) due to having to replenish NO stores

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3
Q

hydralazine contraindications

A

CAD

rheumatic mitral valve disease

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4
Q

minoxidil mechanism of action and use

A

K channel opener
causes hyperpolarization of smooth muscle membrane -> dec. excitation and contraction -> arterial vasodilation
Use:
- refractory HTN
active metabolite can cause hypoTN for 24hrs

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5
Q

minoxidil contraindications

A

acute MI
pheochromocytoma
aortic dissection

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6
Q

minoxidil adverse effects

A

fluid retention
rebound tachycardia
hypertrichosis: hair growth (can be used for alopecia)

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7
Q

fenoldopam mechanism of action and use

A
vasodilator 
D1 receptor agonist 
- dec peripheral vascular resistance and inc. renal blood flow
- inc. diuresis and natriuresis 
Use:
- HTN emergency
- IV: short-term use up to 48 hrs
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8
Q

fenoldopam adverse reactions

A

hypoTN
tachycardia
headache
flushing

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9
Q

Sodium nitroprusside mechanism of action

A

vasodilator
produces NO -> smooth muscle relaxation
vasodilates arteries and veins

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10
Q

sodium nitroprusside use

A

HTN emergencies

  • rapid onset of action
  • very short duration of action
  • IV infusion only
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11
Q

sodium nitroprusside adverse effects

A

risk of cyanide toxicity
-> blurred vision, confusion, tinnitus, seizures, acid-base imbalance, and arrhythmias
metabolized into NO and cyanide -> thiocyanate -> renal excretion

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12
Q

digoxin Mechanism of action

A

considered for all HF pt who have not responded symptomatically to other Rx tx.
- AV nodal and inotropic effects
- inc PSNS outflow
inhibits Na-K ATPase

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13
Q

nitrates

A

nitroglycerin
isosorbide mononitate
isosorbide dinitrate

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14
Q

nitrate mechanism of action

A

inc. concentration of NO in smooth muscle cells
- > activation of cGMP
- > smooth muscle relaxation
dec. venous blood return to the heart
dec. preload

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15
Q

nitroglycerin site of admin

A
sublingual tablets
spray
topical patch or paste
IV
- high first-pass effect 90% degraded in liver
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16
Q

nitroglycerin indication

A

angina tx
angina prophylaxis
BP reduction
preload reduction

17
Q

nitroglycerin contraindications

A

hypoTN
hypersensitivity
phosphodiesterase 5 inhibitor use (erectile meds) -> hypoTN

18
Q

nitroglycerin adverse effects

A
hypoTN 
headache
tachycardia
flushing
N/V
dyspnea
diarrhea
19
Q

hydralazine mode of admin

A

parental
used in HTN urgency/emergency
- rapid first-pass metabolism

20
Q

nitroprusside mechanism of action

A

formation of NO -> arteriovenous smooth muscle relaxation

21
Q

nitroprusside adverse effects

A

renal and hepatic insufficiency

-> cyanide toxicity