Nitric oxide and Nitrovasodilators (Lecture 11) Flashcards
Nitric oxide is synthesised from ___________ to NO via ______ enzyme.
NO is released from _________ and acts upon _________.
Many endogenous vasodilators such as _______(in inflammation) acts through nitric oxide.
L-arginine through endothelial nitric oxide synthase (eNOS).
endothelium and acts upon vascular smooth muscle.
histimine.
How does nitric oxide cause smooth muscle relaxation?
How do extrinsic nitrates actually work?
cGMP is important in vasodilation.
They mimic endogenous NO by releasing NO in plasma or form NO within cells.
What is the organic nitrate that we need to know, what is the drug which spontaneously releases NO into the plasma?
What are their mechanisms of action?
Is the main mechanims of action of nitrates to decrease preload or afterload?
Preload, however afterload is also affected. This is why it is useful in angina because it reduces subendocardial blood flow.
Theraputic uses of nitrodilators?
Also antiplatelet effects of NO.
In an acute hypertensive emergency sodium nitroprisside can be used.
It can decrease oedema as there is venous pressure reduction.
Used in severe and chronic heart failure because it reduces afterload therefore improving ejection fraction and stroke volume.
The pharmacokinetic of nitrates?
What are the side effects of using nitrates?
Tolerance: the way to combat this is by having nitrate free intervals, or increase in dose IV if needed.
What are the main drug interactions with nitrates?
Main one is sildenafil (viagra) which is a potent vasodilator (phosphodiesterase inhibitor) as it inhibits the thing which terminates cGMP action. This is a black box warning.
