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PHARMACOLOGY I > vasodilators > Flashcards

vasodilators Flashcards

1
Q

what things relax vascular smooth muscle

A
  • increasing cGMP, NO, nitrates, PDE5 inhibitors
  • decreasing intracellular Ca
  • Ca channel blockers (CCBs)
  • increasing cAMP in vascular cells (cAMP increases inactivation of myosin light chain kinase)
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2
Q

what is the purpose of vasodilators

A
  • improve CO
  • reduce edema and effusions
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3
Q

vasodilators can affect arterioles and ?

A

venous capacitance vessels

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4
Q

what drugs are vasodilators

A
  • ACEI
  • Nitrites
  • Hydralazine
  • CCBs
  • alpha blockers
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5
Q

what drug that acts through NO is most effective in CHF secondary to mitral valve insufficiency

A

Hydralazine

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6
Q

Hydralazine dilates ____ but not _____

A

arterioles
not veins

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7
Q

symptoms of Hyrdalazine toxicity

A
  • V+, anorexia, tachycardia, sweating, hypotension (Cats)
  • ischemic arrythmias, decompensation
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8
Q

what happens to nitrate compounds

A

they get converted into NO

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9
Q

Nitrates preferentially dilate ?

A

veins but they also dilate arteries

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10
Q

effect of nitrates (NO) on myosin light chains

A

decreases phosphorylation

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11
Q

these drugs have limited use in VetMed and have questionable efficacy in dogs & cats; all uses are extra label

A

Nitrates

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12
Q

what are the uses for Nitroglycerin

A
  • pulmoney edema associated w/ HF
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13
Q

What nitrate dugs have potential for tolerance

A
  • Nitroglycerin
  • Isosorbide dinitrate
    avoid intermittent use
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14
Q

of the 3 nitrate drugs (nitroglycerin, isosorbide dinitrate, sodium nitroprussidae) which one is a potent vasodilator and also doesn’t cause tolerance

A

Sodium nitroprusside

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15
Q

how is Sodium nitroprusside administered

A

CRI, constant infusion

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16
Q

what vasodilator is used in patients with pulmonary edema associated w/ HF and hypertensive crisis

A

Sodium nitroprusside

17
Q

what vasodilator is used to treat pulmonary edema associated with HF

A

Nitroglycerin

18
Q

what are the two important functions of intracellular calcium

A
  • triggers muscular contraction in myocardium + vascular sm
  • needed for the pacemaker activity of the SA node and for conduction through the AV node
19
Q

what opens the heart & vascular smooth muscle Ca channels? what closes them?

A
  • opened by beta adrenergic stimulation to enhance calcium entry
  • closd by CCBs to inhibit calcium entry
20
Q

orally active drugs that bind L-type channels in the myocardium and vascular smooth muscles

A

CCBs

21
Q

CCBs will relax all smooth muscles that depend on _____ for normal resting tone & contraction

A

calcium

22
Q

what are the major cardiac effects of CCBs (3)

A
  • negative inotropic effects (decreased contractility)
  • reduced impulse generation in SA node
  • slowed AV node conduction
23
Q

long acting dihydropyridine Ca channel blocker that causes vasodilation w/out significant cardiac effects

A

Amlodipine besylate

24
Q

vasodilator DOG in hypertensive cats , all uses are extra label

A

Amlodipine besylate

25
Q

what kind of metabolism does Amlodipine besylate undergo

A

hepatic

26
Q

what does Dilitazem do

A

depresses SA and AV node, causes cardiac contractile depression

27
Q

what condition is treated using Dilitazem in cats and in dogs (different)

A

cats - hypertrophic cardiomyopathy
dogs - supraventricular tachycardia

28
Q

what drug needs to be careful when used in nursing mothers and why

A

Diltiazem b/c it is excreted in milk

29
Q

what is the main difference between the effects of Amlodipine and Dilltiazem

A
  • Amlodipine causes more significant vasodilation and reflex tachycardia
  • Diltiazem causes depression of SA and AV node and negative inotropic
30
Q

how do phosophodiesterase 5 inhibitors (PDE5) cause vasodilation

A

inhibition of cGMP, less cGMP = vasodilation

31
Q

what condition is Sildenafil useful in treating

A

pulmonary hypertension in dogs

32
Q

how do alpha 1 adrenergic antagonists work to decrease blood pressure

A
  • blocking alpha one reduces vasoconstriction in arteries and veins caused by NE
  • blood pressure falls due to a decrease in peripheral resistance
33
Q

what is the primary use of Prazosin

A

treatment of functional urethral obstruction in dogs

34
Q

how does prazosin elicit less of a tachycardic reflex

A

prazosin only targets alpha one receptors, not alpha 2

35
Q

what are the adverse effects of prazosin

A
  • hypotension
  • sodium and water retention (increased renin)
36
Q

what is the BA of Diltiazem in dogs vs cats

A

25% in dogs, 50-80% in cats (PO)

37
Q

of all the vasodilators, which drug has the greatest binding to plasma proteins

A

Diltiazem, 70-75% bound to plasma proteins

38
Q

where is Diltiazem metabolized

A

liver

39
Q

this drug decreases the membrane Ca current, causes long-lasting relaxation of vascular smooth muscles and decreases cardiac contractility, automaticity and conduction

A

Amlodipine besylate (CCBs)

PHARMACOLOGY I (21 decks)

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