Treating peripheral vascular disease. Migraine therapy

Question 1

Mechanism of the drugs that treat peripheral vascular disease

Answer 1

Vasodilation

Rheological effect - RBC modification

Platelet inhibition - aggregation inhibitors.

Question 2

Peripheral vascular diseases listed on the elearning

Answer 2

• (3Ns, B3)
  Naftidrofuryl
  Nicergoline
  Niacin (B3)

Cinnarizine and Flunarizine

Vinpocetine
Pentoxifylline

Bencyclane

Question 3

Naftidrofuryl

Answer 3

increases peripheral circulation

SEs: Arrythmia, hypotension, angina

Question 4

Nicergoline

Answer 4

ErGOt derivative, but nicer :D

alpha1 inhibition
platelet inhibition
increases Dopamine in the brain.

Used for peripheral vasc. diseases and sometimes in dementia or cerebral casvular disease.

Question 5

Cinnarizine and Flunarizine

Answer 5

CCBs,
inhibit: 
Ca channels,
Platelet aggregation
RBC rigidity
Histamine receptors

SEs: Depression, sedation

Question 6

Pentoxifylline

Answer 6

Methylxanthine derivative, nonspecific PDE inhibitor.

inhibits platelet aggregation and decreases RBC blood viscocity.

for Atherosclerotic and Diabetic PVD.
claudication
sickle cell anemia

Orally admined, 
SEs: 
GI upset, tachycardia, 
angina
flushing

Question 7

Niacin

Answer 7

Decreases VLDL and LDL levels, (decreasing triglycerides)
Mild increase in HDL, most effective HDL increaser.

Rx:
Atherosclrotic PVD
Vasospastic PVD

SE:
LIVER damage, possibly severe. Liver monitoring is manditory.
flushing - caused by prostaglandins, limited by NSAID pretreatment
Hypotension
Tachydcardia
Hyperglycemia
Hyperuricemia and Gout - Allopurinol.

Question 8

Ones not listed on the elearning

Answer 8

Amlodipine and the dihydropyridine CCBs are 1st line for Raynauds

Cilostazol and Dipyridamole - PDE inhibitors, treat symptoms of PAD. inhibit platelet aggregation and cause arteriolar vasodilation.

Clopidogrel, Prasugrel, Ticagrelor, and Ticlodipine ADP receptor P2Y12 inhibitors.
-prophylaxis to decrease the associated MI risk.

Statins are indicated in PAD.
-Decrease atherosclerosis and MI risk.