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CPR 1st half > Vasodilating Drugs > Flashcards

Vasodilating Drugs Flashcards

1
Q

sodium nitroprusside

A

vasodilator –> spontaneous nonenzymatic NO release
nonspecific - dilates arteries AND veins (decrease afterload and preload)
HTN emergencies –> fast acting but toxicity limits use
**can cause cyanide accumulation –> NOT for patients with renal issues

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2
Q

what is the toxicity associated with sodium nitroprusside?

A

cyanide accumulation (–>cyanide–>thiocyanate –> kidneys)
can cause acid/base issues, arrhythmias, death
DO NOT USE WITH RENAL ISSUES

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3
Q

minoxidil

A

vasodilator, K+ channel opener
hyperpolarization causes arteriolar smooth m relaxation
doesnt affect veins
coadminister with B blocker to avoid reflex
BUT can evoke sympathetic reflex (increase HR, renin, contractility)

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4
Q

Rogaine

A

topical minoxidil
minoxidil, a K+ channel opener, increases hair growth
can have CV effects

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5
Q

what drug opens K+ channels?

A

minoxidil

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6
Q

hydralazine

A 
oral
directly vasodilates smooth m arterioles
decreases TPR (afterload) and BP
can cause sympathetic relfex(HR increase, renin retention)
Use with pregnancy HTN
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7
Q

drug for HTN associated with pregnancy?

A

hydralazine

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8
Q

clonidine

A

CNS central acting vasodilator (sympathoLYTIC)
stimulates alpha2A receptor in brainstem to decrease sympathetic outflow!
BUT high doses reverse the effect –> activate alpha 2B on vascular smooth m and cause vasoconstriction

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9
Q

what happens with high doses of clonidine?

A

lose dilation effect

activates alpha 2B receptor in smooth m which causes vasoconstriction

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10
Q

alpha 2A vs alpha 2B receptors

A

2A is in CNS and causes vasodilation(decrease sympathetic)

2B is in vascular smooth m and vasoconstricts

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11
Q

guanadrel

A

false neurotransmitter that is inactive at postganglionic adrenergic receptors
taken up by NE transporter and replaces NE in vesicles
BUT there is potential for NE release so DONT USE WITH pheochromocytoma

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12
Q

risk of guanadrel?

A

since it is a false neurotransmitter there is a chance NE could be released

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13
Q

reserpine

A

binds to storage vesicles in CNS and PNS and inhibits transport and storage of NE/dopa

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14
Q

categories of ca channel blockers

A

dihydropyridine

non-dihydropyridine

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15
Q

vasodilating dihydropyridine? and nondihydropyridine?

A

di- nifedipine

non-verapamil

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16
Q

ca ch blockers (dihydro/nondihydro) effects

A

both act on smooth m (artery>venous) AND myocardium
inhibit L-type Ca channels
decreases contractility and Sa rate/av conductivity
dont affect skeletal muscle

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17
Q

verapamil

A

nondihydropyridine
L type ca ch blocker , affects vessels and heart
vasodilates vessels
decreases SA rate and AV conduction velocity
use: HTN and arrythmias
BUT can cause ecessive vasodilation, ,AV node block, and decreased CO

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18
Q

T/F: verapamil only affects smooth m?

A

FALSE

it affects vessels AND myocardium (SA rate and AV conduction v)

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19
Q

nifedipine

A

dihydropyridine
L type ca ch blocker, smooth m and myocardium
keeps intracellular Ca LOW
reflex causes increase in HR and contractility
use with heart failure

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20
Q

which to use with heart failure: nifedipine or verapamil

A

nifedipine due to reflex

verapamil can cause excess dilation and AV node block/decreased CO

21
Q

PDE inhibitors

A

phosphodiesterase inhibitors
prevent hydrolysis of cAMP or cGMP to their inactive form –>increased cAMP = + inotropism of heart
vasodilation! = ‘inodilators’
2 drugs = theophylline and sildenafil
can cause thrombocytopenia/ increase in mortality?

22
Q

what category can cause thrombocytopenia?

A

PDE inhibitors

23
Q

sildenafil

A

PDE inhibitor, prevents breakdown of cGMP –> dilation and decrease preload/afterload = +inotropism
selective for PDE5(cGMP) which is in penile, retina, and vasculature
treat: erectile dysfunction

24
Q

what drug treats erectile disfunction?

A

sildenafil

25
Q

nitroglycerin

A 
organic nitrate used to vasodilate (release NO)
treat: angina, HTN, ischemia, after coronary bypass
venous dilation(>artery)
26
Q

after a coronary bypass, give the patient…

A

nitroglycerin

27
Q

phentolamine

A

nonselective alpha blocker, vasodilates

use for patients with catecholamine emergencies

28
Q

esmolol

A

B blocker, vasodilates

use: aortic dissection and postop HTN

29
Q

vasodilator to treat after aortic dissection?

A

esmolol

30
Q

vasodilator for postop HTN?

A

esmolol

31
Q

labetolol

A

alpha and B blocker, vasodilates

Use for active coronary disease patients

32
Q

fenoldopam

A

dopamine receptor 1 agonist
activates D1 and vasodilates
increases renal perfusion
Use for patients with renal disfunction

33
Q

drug to vasodilate in renal disfunction patients?

A

fenoldopam

34
Q

drugs to use for quick/emergency acute HTN?

A

sodium nitroprusside is fastest (seconds)

minutes: clevidipine, fenoldopam, labetolol, phentolamine

35
Q

Long term chronic HTN drugs

A

prazosin, doxasin, clonidine, guanabenz/reserpine, hydralazine, minoxidil

36
Q

amlodipine

A

ca ch blocker, dihydropyridine
vasodilates and decreases BP
Use with patients with COPD, CHF, CAD

37
Q

prazosin

A

alpha1 antagonist, vasodilator

38
Q

atenolol

A

nonselective B antagonist, blocks B1 and B2

vasodilator

39
Q

what vasodilator blocks B1 and B2?

A

atenolol and propanolol

40
Q

propanolol and sotalol

A

B1 and B2 nonselective antagonist

vasodilator

41
Q

carvedilol

A

alpha1, B1 and B2 blocker/antagonist

vasodilates

42
Q

what drug blocks B1, B2 AND alpha1 but not alpha 2

A

carvedilol

43
Q

captopril

A

ACE(angiotensin converting enzyme) inhibitor, vasodilates using RAAS system
inhibits renal function and vasodilates

44
Q

spironolactone and eplerenone

A

aldosterone receptor antagonist, vasodilator

45
Q

losartan

A

ARB (angiotensin 2 receptor antagonist)
decrease in TPR, vasodilates
use with patients who cant tolerate ACE inhibitors

46
Q

what drugs use RAAS system to vasodilate?

A 
captopril
spironolactone
eplerenone
losartan
aliskiren
47
Q

aliskiren

A

renin inhibitor, vasodilates

48
Q

direct vasodilating drugs?

A

hydralazine, minoxidil, sodium nitroprusside

49
Q

clevidipine

A

PDE inhibitor

CPR 1st half (11 decks)

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