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T&D III exam 1 > Vasodilator > Flashcards

Vasodilator Flashcards

1
Q

Calcium channel blockers

A

Dihydropyridines

Non-dihydropyridines

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2
Q

Dihydropyridines

A

Amlodipine

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3
Q

Non-dihydropyridines

A

Verapamil

Diltiazem

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4
Q

CCB

MOA

A

decrease calcium influx

BV and heart

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5
Q

Vascular Effects of CCB

A

arteriodilation – dec TPR – dec BP

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6
Q

Which CCB is more potent for vascular effects?

A

Dihydropyridines

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7
Q

Cardiac effects of CCB

A

Inhibit L-type calcium channels

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8
Q

Which phase/where does CCB inhibit

A

Phase 0 depolarization - SA and AV nodes

Phase 2 of Action Potential - muscle

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9
Q

Which CCB is better for cardiac effects?

A

Verapamil then Diltiazem then Dihydropyridines

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10
Q

CCB

best for Vasodilation ?

A

DHP

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11
Q

CCB best overall?

A

Verapamil

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12
Q

ADR

Verapamil

A 
Hypotension
CHF
AV block
Edema
HA
Constipation
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13
Q

ADR

DHP

A

Hypotension
Edema
HA

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14
Q

How is ADR for Diltiazem different from Verapamil?

A

No HA or constipation

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15
Q

what’s a CI for all CCB?

A

Severe hepatic dysfunction

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16
Q

CI for non-DHP

A

LV dysfunction

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17
Q

What should you avoid with CCB? why?

A

Short-acting agents

- increases mortality

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18
Q

Sick sinus syndrome

A

Verap

dilt

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19
Q

Drug interaction with CCB (more sp Verap)

A

CYP3A4 inhibitors/inducers
Concurrent beta-blockers
Digoxin
Antiarrhythmic

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20
Q

K-channel openers

Moa

A

inc K+ efflux from vascular SM

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21
Q

Example of K-channel opener

A

Minoxidil

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22
Q

What does Minoxidil do

A

arterial vasodilator – dec TPR

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23
Q

What’s significant about Minoxidil?

A

Marked compensatory responses

  • inc HR, inc CO, inc Fluid retention
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24
Q

Therapeutic use of Minoxidil

A

Refractory/malignant hypertension

25
Q

How do you deal with the adverse effects caused by Minoxidil

A

Loop diuretic - fluid retention

BB - Tachy

26
Q

What can result from marked fluid retention?

A

Pericardial effusion/cardiac tamponade

27
Q

What’s ADR of Minoxidil that is used for therapeutic use?

A

Hypertrichosis – Rogaine

28
Q

MOA

Guanylyl Cyclase activators

A

Activate GC

inc cGMP – vasodilation

29
Q

Examples of GCA

A

Nitroprusside
Organic Nitrates
Hydralazine

30
Q

Overall effect of Nitroprusside

A

dec TPR, CO, BP

inc HR

31
Q

Delivery of nitroprusside

A

IV

32
Q

Therapeutic use - Nitroprusside

A

Hypertensive ER
Acute CHF
MI

33
Q

ADR Nitroprusside

A

Acute hypotension

Chronic thiocyanate/cyanide toxicity

34
Q

How is cynide toxicity avoided with nitroprusside?

A

Thiosulfate

35
Q

What is the enzyme that converts cyanide and thiosulfate to thiocyanate

A

Rhodanase

36
Q

Thiocyanate toxicity

A

weakness
nausea
disorientation
delerium

37
Q

Cyanide toxicity

A

CN-cytochrome oxidase
cytotoxic anoxia
hypoxia, convulsions, respiratory arrest

38
Q

Example of organic nitrates

A

Nitroglycerin

Longer acting nitrates

39
Q

Example of longer acting nitrates

A

Isosorbide Dinitrate/Mononitrate

40
Q

How is organic nitrates different from nitroprusside

A

organic nit - more venodilation

Nitroprusside - equal veno-/arterio-dilation

41
Q

Dose effect for organic nitrates

A

low dose - only veno

high dose - both veno and arterio

42
Q

Pharmacokinetics for organic nitrates

A

Extensive first pass elimination

Sublingual, transdermal, IV

43
Q

Organic nitrates therapeutic use

A

Angina
CHF

Acute MI

44
Q

ADR - organic nitrates

A

Excessive hypotension

Tolerance

45
Q

what is the therapeutic use for NO

A

hypoxic respiratory failure term/near-term neotnates with pulmonary hypertension

46
Q

ADR NO

A

pulmonary edema

hypoxemia upon sudden withdrawal

47
Q

Therapeutic effect of Hydralazine

A

CHF

48
Q

Hydralazine ADR

A

Fluid retention
Tachy

+ANA – lupus like syndrome

49
Q

Is there reneal involvement with +ANA in Hydralazine?

A

no

50
Q

D1 receptor agonist

A

Fenoldopam

51
Q

Use for Fenoldopam

A

hypertensive emergency

52
Q

PDE-inhibitors

A

Sildenafil
Tadalafil
Vardenafil

53
Q

which type PDE is inhibited

A

type 5

54
Q

What does PDE-I do

A

potentiate effects of NO – inc cGMP

55
Q

PDE-I – Smooth muscles in _____ are _____ resulting in increased/decreased __________

A

Coprpus cavernosum and lower urinary tract

relax

increased erection and urination

56
Q

USE - PDE-I

A

erectile dysfunction

57
Q

Kinetic - PDE-I

A

Oral

58
Q

What is Tadafil used for specifically?

A

BPH

59
Q

Drug interactions - PDE-I

A

Organic nitrates
alpha-blockers

Cyp3A4 drugs

T&D III exam 1 (11 decks)

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