Pharm 21 - Vascular Tone

Question 1

MOA:Donates NO–>activates guanylyl cyclase and increases dephosphorylation of myosin light chain in vascular smooth muscle= vasodilation

Answer 1

Nitrates, Inhaled NO, Sodium Nitroprusside

Question 2

Tx: short acting (sublingual), long acting (oral) angina

Answer 2

Isosorbide dinitrate

Question 3

Consideration: venous dilation greater than arteriolar

Answer 3

isosorbide dinitrate

Question 4

Organic Nitrates (5)

Answer 4

isosorbide dinitrate, isosorbide 5-mononitrate, nitroglycerin, sodium nitroprusside, inhaled NO gas

Question 5

Tx: prophylaxis angina, chronic IHD

Answer 5

isosorbide 5-mononitrate

Question 6

consideration: 100% bioavailable orally

Answer 6

Isosorbide 5-mononitrate

Question 7

Tx: Agnina attacks, chronic IHD, acute heart failure

Answer 7

Nitroglycerin (NTG)

Question 8

Consideration: Ergotamine may oppose coronary vasodilation of nitrates

Answer 8

NTG

Question 9

Tx: HTN emergency, severe cardiac failure, Ergot alkaloid toxicity

Answer 9

Sodium nitroprusside

Question 10

Consideration: cyanide toxicity (thiocyanate toxicity)

Answer 10

sodium nitroprusside

Question 11

Tx:Neonatal respiratory failure

Answer 11

inhaled NO gas

Question 12

Consideration:selectively dilates pulmonary vasculature

Answer 12

inhaled NO gas

Question 13

Phosphodiesterase Type V (PDE5) Inhibitors (3)

Answer 13

Sildenafil, Vardenafil, Tadalafil

Question 14

MOA:Inhibit PDE5 (enzyme for converting cGMP to GMP) cGMP normally relaxes vessels= dilation (PDE5 inactivate cGMP–>GMP)

Answer 14

Phosphodiesterase Type 5 (PDE5) Inhibitors

Question 15

Tx:Erectile dysfunction

Answer 15

PDE5 inhibitors

Question 16

consideration:concomitant use of organic nitrate vasodilators= Hypotension

Answer 16

PDE5 inhibitors

Question 17

Calcium channel blockers (CCB)

Answer 17

Dihydropyridines: Nidfedipine, amlodipine, felodipine, clevidipine; Benzothiazepine: Diltiazem; Phenylalkylamine: Verapamil

Question 18

MOA:Block influx of calcium (L-type channels)= no actin myosin cross bridge formation= no contraction= dilation

Answer 18

Calcium channel blockers

Question 19

Tx:Angina, HTN, Raynaud’s phenomenon, Pre-eclampsia

Answer 19

Dihydropyridines (CCB)

Question 20

Considerations:Amlodipine has higher bioavailability, longer peak time, slower metabolism

Answer 20

Dihydropyridines (CCB)

Question 21

Tx Same as Phenylalkylamine):Prinzmetal angina, HTN, A-fib, Paroxysmal SVT

Answer 21

Benzothiazepine

Question 22

Benzothiazepine medication name

Answer 22

Diltiazem

Question 23

Dihydropyridine medications name (4)

Answer 23

Nidfedipine, Amlodipine, Felodipine, Clevidipine

Question 24

Tx (same as Dihydropyridines):Prinzmetal angina, HTN, A-fib, Paroxysmal SVT

Answer 24

Phenylalkylamine

Question 25

Consideration:concomitent alcohol use will increase alcohol concentration

Answer 25

Phenylalkylamine

Question 26

Phenylalkylamine medication name

Answer 26

Verapamil

Question 27

MOA:Open ATP modulated K+ channels to hyperpolarize membrane= decreased influx of calcium= dilation

Answer 27

K+ channel openers

Question 28

K+ channel opener medications (4)

Answer 28

minoxidil, pinacidil, nicorandil, cromakalim

Question 29

Tx:Severe/refractory HTN; male alopecia (topical minoxidil)

Answer 29

K+ channel openers

Question 30

Considerations:typically used with B-blockers and diuretic

Answer 30

K+ channel openers

Question 31

MOA:Block avtivation of endothelin receptors (ETa,b)

Answer 31

Endothelin Receptor Antagonists

Question 32

Tx:Pulmonary HTN

Answer 32

Endothelin Receptor Antagonists

Question 33

Considerations:hepatotoxicity (monthly monitoring), No pregnancy use

Answer 33

Endothelin Receptor Antagonists

Question 34

Endothelin Receptor Antagonist medications (2)

Answer 34

Bosentan, Ambrisentan

Question 35

MOA:Arteriolar vasodilator

Answer 35

Hydralyzine

Question 36

Tx:Severe HTN, Severe Heart failure

Answer 36

Hydralyzine

Question 37

considerations:cause reversible SLE, Usually used with Isosorbide dinitrate; morbity/mortality benefits for blacks wtih advanced heart failure

Answer 37

Hydralyzine

Question 38

a-1 Adrenergic Antagonist medications (3)

Answer 38

Prazosin, Doxazosin, Terazosin

Question 39

B-Adrenergic Antagonist medications (3)

Answer 39

Propanolol (nonselective), Atenolol, Metoprolol (B1-selective)

Question 40

ACE Inhibitor medications (3)

Answer 40

Captopril, Lisinopril, Enalopril

Question 41

AT1 REceptor Antagonist medications (2)

Answer 41

Losartan, Valsartan

Question 42

MOA:Inhibit cleavage of Angiotensin (AT) I to ATII by ACE; Inhibit defradation of bradykinin by kininase II

Answer 42

ACE Inhibitors