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: Diltiazem

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