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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
How do you deal with the adverse effects caused by Minoxidil
Loop diuretic - fluid retention | BB - Tachy
26
What can result from marked fluid retention?
Pericardial effusion/cardiac tamponade
27
What's ADR of Minoxidil that is used for therapeutic use?
Hypertrichosis -- Rogaine
28
MOA Guanylyl Cyclase activators
Activate GC | inc cGMP -- vasodilation
29
Examples of GCA
Nitroprusside Organic Nitrates Hydralazine
30
Overall effect of Nitroprusside
dec TPR, CO, BP inc HR
31
Delivery of nitroprusside
IV
32
Therapeutic use - Nitroprusside
Hypertensive ER Acute CHF MI
33
ADR Nitroprusside
Acute hypotension Chronic thiocyanate/cyanide toxicity
34
How is cynide toxicity avoided with nitroprusside?
Thiosulfate
35
What is the enzyme that converts cyanide and thiosulfate to thiocyanate
Rhodanase
36
Thiocyanate toxicity
weakness nausea disorientation delerium
37
Cyanide toxicity
CN-cytochrome oxidase cytotoxic anoxia hypoxia, convulsions, respiratory arrest
38
Example of organic nitrates
Nitroglycerin | Longer acting nitrates
39
Example of longer acting nitrates
Isosorbide Dinitrate/Mononitrate
40
How is organic nitrates different from nitroprusside
organic nit - more venodilation Nitroprusside - equal veno-/arterio-dilation
41
Dose effect for organic nitrates
low dose - only veno high dose - both veno and arterio
42
Pharmacokinetics for organic nitrates
Extensive first pass elimination | Sublingual, transdermal, IV
43
Organic nitrates therapeutic use
Angina CHF Acute MI
44
ADR - organic nitrates
Excessive hypotension | Tolerance
45
what is the therapeutic use for NO
hypoxic respiratory failure term/near-term neotnates with pulmonary hypertension
46
ADR NO
pulmonary edema | hypoxemia upon sudden withdrawal
47
Therapeutic effect of Hydralazine
CHF
48
Hydralazine ADR
Fluid retention Tachy +ANA -- lupus like syndrome
49
Is there reneal involvement with +ANA in Hydralazine?
no
50
D1 receptor agonist
Fenoldopam
51
Use for Fenoldopam
hypertensive emergency
52
PDE-inhibitors
Sildenafil Tadalafil Vardenafil
53
which type PDE is inhibited
type 5
54
What does PDE-I do
potentiate effects of NO -- inc cGMP
55
PDE-I -- Smooth muscles in _____ are _____ resulting in increased/decreased __________
Coprpus cavernosum and lower urinary tract relax increased erection and urination
56
USE - PDE-I
erectile dysfunction
57
Kinetic - PDE-I
Oral
58
What is Tadafil used for specifically?
BPH
59
Drug interactions - PDE-I
Organic nitrates alpha-blockers Cyp3A4 drugs

T&D III exam 1 (11 decks)

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