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Pharmacology > Organic nitrates > Flashcards

Organic nitrates Flashcards

1
Q

What is Sodium Nitroprusside

A

potent vasodilator and venodilator

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2
Q

MOA of Sodium Nitroprusside

A

acts on Sulfhydryl groups to produce nitric oxide
NO then stimulates GC to GTP-cGMP
–>vasodilation of arteries+ venodilation
incr. cGMP decr. P-MLC= decr contraction of vessels

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3
Q

Effects of Sodium Nitroprusside

A

decr. TPR–> decr. afterload
Venodilation= incr. capacitance

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4
Q

Admin of sodium notroprusside

A

IV infusion
short half-life
metabolised in liver

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5
Q

AEs of Sodium Nitroprusside

A

Generates CN- groups: caution with hepatic patients
Lactic acidosis

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6
Q

Which is a NO donor

A

Hydralazine: oral 2nd/3rd line antihypertensive
add-on therapy

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7
Q

MOA of Hydralazine

A

causes generation of NO=GC stimulation=incr. cGMP

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8
Q

Effects of Hydralazine

A

incr cGMP=vasodilation of VSM in arterioles
–> decr in TPR

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9
Q

TU of Hydralazine

A

HTN but usually combined with weak diuretic and a B-Blocker
–>bcos of Na and H20 retention+tachycardia
HF with long acting nitrate in patients who are intolerant to ACEs/ARBs

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10
Q

AEs of Hydralazine

A

Tachycardia when used with B-Blocker
SLE: systemic lypus erthro…
haemolytic anaemia
Na+H2O retentio when used thiazide

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11
Q

Where do the organic nitrates act

A

mainly on veins

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12
Q

What is Glyceryl Trinitrate

A

a short acting organic nitrate

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13
Q

Admin of Glyceryl Trinitrate

A

Cannot be taken orally: bioav. 0%
Given as oral spray under tongue or IV

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14
Q

MOA of Glyceryl Trinitrate

A

incr. cGMP levels by stimulating GC
=relaxation of muscle cell in both veins and arteries

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15
Q

Effects of Glyceryl Trinitrate

A

incr. venous capacitance
more blood is stored=less blood returned to heart–> EDP drops, decr. wall stress and decr. Os consumption–> decr VR= angina relief
-Also shunts blood to ischaemic areas of heart
-causes coronary vasodilation
drop in TPR
reflex incr. in HR

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16
Q

TUs of Glyceryl Trinitrate

A

-short-term angina stoppage by decr. preload
-Aborts exercise induced angina by rapidly incr. capacitance and decr. VR
-can be used in patients with suspected MI to reduce preload and cardiac congestion

17
Q

AEs of Glyceryl Trinitrate

A

Headache: intense vasodilation
Tachycardia
Hypotension

18
Q

CI of Glyceryl Trinitrate

A

PDE-5 inhibitors: sildenafil

19
Q

What is Isosorbide Dinitrate

A

is a short acting nitric oxide donor

20
Q

Admin of Isosorbide Dinitrate

A

given sublingually: intermediate bioav.
not given orally as first pass metabolism can be up to 80%
onset of action: 30s
DOA of 5-10mins

21
Q

MOA of Isosorbide Dinitrate

A

incr. cGMP by stimulating GC
–> relaxation of muscle cells in both veins and arteries

22
Q

effects of Isosorbide Dinitrate

A

incr. venous capacitance
more blood is stored=less blood returned to heart–> EDP drops, decr. wall stress and decr. Os consumption–> decr VR= angina relief
-Also shunts blood to ischaemic areas of heart
-causes coronary vasodilation
drop in TPR
reflex incr. in HR

23
Q

TUs of Isosorbide Dinitrate

A

-short-term angina stoppage by decr. preload
-Aborts exercise induced angina by rapidly incr. capacitance and decr. VR
-can be used in patients with suspected MI to reduce preload and cardiac congestion

24
Q

AEs of Isosorbide Dinitrate

A

Headache
Tachycardia
Hypotension

25
Q

CIs of Isosorbide Dinitrate

A

Sildenafil

26
Q

What is Isosorbide mononitrate

A

long acting nitric oxide donor

27
Q

Admin of Isosorbide mononitrate

A

can be taken orally: bioav. 100%
No first pass
DOA of 5-8hrs

28
Q

MOA of Isosorbide mononitrate

A

Depletes SH groups in endothelium
incr. cGMP by stimulating GS
–> relaxation of veins and a`rteries

29
Q

Effects of Isosorbide mononitrate

A

Same as other organic nitrates

30
Q

TUs of Isosorbide mononitrate

A

Prophylaxis in angina
Long term treatment of angina oectoris: taken twice daily
Tachypylaxis: after 8hrs

31
Q

AEs of Isosorbide mononitrate

A

Headache
Hypotension
Tachycardia

32
Q

CI of Isosorbide mononitrate

A

Sildenafil

33
Q

MOA of Nitric Oxide

A

Venodilation> vasodilation
incr. Capacitance
Decr. VR
reduced LV wall stress
Reduced O2 consumption
Coronary vasodilation
Redistribution of oxygenated blood to ischaemic LV

Pharmacology (50 decks)

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