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Pharmacology 2 > Vasodilator > Flashcards

Vasodilator Flashcards

1
Q

What controls BP

A

Directly related to cardiac output and peripheral vascular resistance

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2
Q

What are CO and peripheral resistance controlled by

A
  1. Baroreceptors/flexors

2. Renin-angiotensin-aldosterone system

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3
Q

How do most antihypertensive drugs work

A

By reducing CO or decreasing peripheral vascular resistance

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4
Q

How does the baroreceptor system work

A

Controls BP and CO by changing the sympathetic/parasympathetic response mechanisms of the heart. Sympathetics cause vasoconstriction, which increases CO and BP

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5
Q

How does the renin system work

A

The kidneys control BP by altering blood volume in the body

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6
Q

What does angiotensin II do

A

Potent vasoconstrictor that causes increase in BP. Activated by ACE in the kidney

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7
Q

Name 3 classes of calcium channel blockers

A
  1. Dihydropyridines
  2. (di)Phenylalkylamines
  3. Benzothiazepines
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8
Q

What is the only phenylalkylamine that is approved in the US

A

Verapamil

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9
Q

What is the only benzothiazepine used in the US

A

Diltiazem

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10
Q

What are 2 dihydropyridines that are used

A
  1. Nifedipine (adalat)

2. Amlodipine

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11
Q

What is the MOA for calcium channel blockers

A

Inhibits or blocks the calcium ion channels which prevents ca+ from entering the muscle cells. This causes a decrease in smooth muscle contraction and increases vasodilation. (DO NOT DILATE VEINS)

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12
Q

Uses of CCB

A

Hypertension in pts who also have asthma, diabetes, angina.

Really effective in black people

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13
Q

Uses of diphenylalkylamines

A

Cardiac and smooth muscle cells. Good for treating angina!

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14
Q

Uses of benzothiazepines

A

Cardiac and smooth muscle cells. Can be used to treat angina and hypertension.

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15
Q

Uses of dihdropyridines

A

Much greater affinity for vascular ca+ channels. Great for treating hypertension

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16
Q

Adverse effects of CCB

A
  1. Constipation
  2. Dizziness
  3. fatigue
  4. no verapamil in CHF pts
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17
Q

Name 2 ACE inhibitors

A
  1. Lisinopril (zestril)

2. Captopril (Capoten)

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18
Q

When are ACE inhibitors used

A

When 1st line drugs are contraindicated or ineffective or in diabetic patients

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19
Q

MOA of ACE inhibitors

A

Lower BP by reducing peripheral vascular resistance without increasing CO,rate or contractility. Blocks the ACE which is responsible for inducing Angiotensin II which is a potent vasoconstrictor. WORK ON BOTH ARTERIES AND VEINS

20
Q

What is the effect of ACE inhibitors on cardiac output

A

Reduces preload and after load, which decreases cardiac work

21
Q

What are ACE inhibitors used for

A
  1. Gold standard for treating heart failure
  2. MI
  3. hypertension in young white pts, can be used with diuretics
  4. Coronary artery disease
22
Q

Adverse effects of ACE inhibitors

A
  1. Dry cough (due to increased bradykinin)
  2. Hyperkalemia
  3. Skin rash
  4. Hypotension
  5. fever
23
Q

What is the major contraindication of CCB

A

Never use short acting version of dihydropyridines for angina!!

24
Q

What are some contraindications for ACE inhibitors

A
  1. HX of angioedema
  2. Bilateral renal stenosis
  3. Pregnant
25
Q

Name 2 angiotensin receptor blockers (ARBs)

A

Valsartan (diovan) and Losartan (cozaar)

26
Q

What is the MOA of ARBs

A

Block directly at the angiotensin I receptors, which does not allow for angiotensin II to be created which decrease vasoconstriction. WORK ON BOTH ARTERIES AND VEINS

27
Q

What are the uses of ARBs

A
  1. CHF patients that are intolerant to ACEI
  2. Hypertension
  3. MI
  4. Diabetic nephropathy
28
Q

Contraindications of ARB

A
  1. hypersensitivity
  2. Bilateral renal artery stenosis
  3. Pregnancy
29
Q

Name a renin inhibitor

A

Aliskiren (tekturna)

30
Q

MOA for renin inhibitors

A

Directly inhibits renin which means it as earlier in the renin-angiotensin system than ACEI or ARBs do.

31
Q

What are the uses of renin inhibitors

A
  1. Hypertension

2. Heart failure pts (not nearly as often used as ACEI or ARBs for this)

32
Q

Adverse effects of renin inhibitors

A
  1. Diarrhea
  2. Cough
  3. angioedema
33
Q

Contraindications of renin inhibitors

A
  1. pregnant women
  2. hypersensitivity
  3. Hyperkalemia
34
Q

Name 2 centrally acting adrenergic drugs (sympatholytics)

A

Clonidine (catapres) and methyldopa (aldomet)

35
Q

What is the MOA of centrally acting sympatholytics

A

Blocks sympathetic activity by binding to and activating alpha 2 adrenoreceptors in the brain. Blocks sympathetic effects and epinephrine release

36
Q

What is the use of centrally acting sympatholytics

A
  1. Hypertension that does not respond to treatment with 2 or more drugs (clonidine specifically)
  2. Hypertension in pregnant women (methyldopa)
37
Q

Adverse effects of centrally acting sympatholytics

A
  1. Dry mouth
  2. Constipation
  3. Rebound hypertension
  4. Sedation and drowsiness
38
Q

Name some direct vasodilators

A

(hydralazine) Nitroglycerin and isosorbide dinitrate (Isordil)

39
Q

MOA of the direct vasodilators

A

Direct relaxation of peripheral smooth muscles. Accumulation of cGMP which decreases Ca+ used in muscle contraction

40
Q

Name 2 phosphodiesterase inhibitors

A

Sildenafil (viagra) and Tadalafil (cialis)

41
Q

What is the MOA of phosphodiesterase inhibitors

A

Selective inhibition of an enzyme in the corpus cavernosa that results in increase concentrations of cGMP which causes a decrease in vasoconstriction. This allows for more blood flow to the penis

42
Q

Adverse effects of direct vasodilators

A
  1. Headache
  2. Hypotension
  3. Reflex tachycardia
43
Q

What are the direct vasodilatros used for

A
  1. Hypertension

2. CHF in combo with nitrates

44
Q

What are phosphodiesterase inhibitors used for

A

Erectile dysfunction

45
Q

Adverse effects of phosphodiesterase inhibitors

A
  1. Flushing
  2. rash
  3. GI symptoms
  4. dizziness
  5. MI
  6. Optic neuropathy

Pharmacology 2 (8 decks)

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