Vasodilators and Sympathoplegics

Question 1

Calcium Channel Blockers

Answer 1

Dihydropyridines
Non-dihydropyridines

Block calcium influx of SM, cardiac, and SA, AV nodes
Decrease resistance, increase BF
Negative ionotropic effects

HTN, HTN emergencies, angina

Question 2

Dihydropyridines

Answer 2

**Amlodipine
**Nifedipine
Clevidipine
Felodipine
Isradipine
Nicardipine
Nisoldipine

MOA: block L-type vascular calcium channels > cardiac channels

Vasodilation causing reflex sympathetics counteracts any negative ionotropic effects
Long half life minimize reflex

Question 3

Non-dihydropyridines

Answer 3

• *Diltiazem
• *Verapamil

MOA: non-selective block of L-type vascular and cardiac calcium channels

Decrease SA node firing and slow conduction

Question 4

Potassium Channel Openers

Answer 4

Diazoxide
Minoxidil

MOA: hyperpolarize muscle cells

Question 5

Dopamine Agonist

Answer 5

Fenoldopam

D1 agonist receptor
Increase kidney BF
Arteriole dilation, natriuretic

Emergency and post-op HTN

HA and tachy
Avoid with glaucoma

Question 6

Nitric Oxide Modulators

Answer 6

**Hydralazine
**Nitroprusside
Organic Nitrates (Isosorbide dinitrate, nitroglycerin)

Increase NO to vasodilate
Relax veins
Decrease TPR, decrease preload and afterload

HTN emergencies, angina, HF

Question 7

Beta Blockers

Answer 7

**Atenolol
**Carvedilol
**Labetalol
**Metoprolol
**Propranolol
Acebutolol
Betaxolol
Bisoprolol
Carteolol
Esmolol
Nadolol
Nebivolol
Penbutolol
Pindolol
Timolol

HTN with MI, HF, decreased left ventricular function
Predispose to DM
Asthma relative contraindication
Less stroke prevention

Question 8

Alpha 1 Blockers

Answer 8

**Prazosin
Doxazosin
Terazosin
Prevent vasocontriction
Relax prostate
Water and salt retention

Question 9

Centrally acting Alpha 2 Agonists

Answer 9

**Clonidine
**Methyldopa
Guanabenz
Guanfacine
Reduce sympathetic outflow

Question 10

Amlodapine

Answer 10

DHP - CCB

High first pass effect

Question 11

Nifedipine

Answer 11

DHP - CCB
Can be used IV
Shorter half life

Question 12

Clevidipine

Answer 12

DHP - CCB
Can be used IV
Shorter half life

Question 13

Felodipine

Answer 13

DHP - CCB

Minimize cardiac effects

Question 14

Isradipine

Answer 14

DHP - CCB

Long half life

Question 15

Nicardipine

Answer 15

DHP - CCB

Question 16

Nisoldipine

Answer 16

DHP - CCB

Question 17

Ditiazem

Answer 17

CCB

Can cause lupus like rash

Question 18

Verapamil

Answer 18

CCB
Strongest negative ionotropic effect
**Constipation

Question 19

Diazoxide

Answer 19

Potassium channel opener
Vasodilation
Decreased use for HTN emergencies

Excessive hypotension (MI)
Hyperglycemia

Question 20

Minoxidil

Answer 20

Potassium channel opener
Severe HTN
Used for baldness

HA and sweating, hypertrichosis
Reflex tachycardia

Question 21

Fenoldopam

Answer 21

Dopamine agonists

Question 22

Hydralazine

Answer 22

NO Modulator
Increase NO to vasodilate
HTN in pregnancy, HF esp in AA, emergency

HA, N, anorexia, sweating
Tachycardia problem with ischemic heart disease

Question 23

Nitroprusside

Answer 23

NO modulator

Hypotension
Cyanide poisoning

Question 24

Isosorbide dinitrate

Answer 24

NO modulator

Relax veins

Question 25

Nitroglycerin

Answer 25

NO modulator Relax veins Orthostatic hypotension, syncope, throbbing headache

Question 26

Atenolol

Answer 26

B1 selective blocker Non-ISA HTN

Question 27

Carvedilol

Answer 27

B1, B2, and A1 blocker ISA Vasodilator HF

Question 28

Labetalol

Answer 28

``` B1, B2, and A1 blocker ISA - B2 agonist Vasodilator IV for severe HTN Can use during pregnancy ```

Question 29

Metoprolol

Answer 29

``` B1 selective Non-ISA HTN HF Ischemic heart disease ```

Question 30

Propranolol

Answer 30

B blocker Non-ISA Ischemic heart disease

Question 31

Acebutolol

Answer 31

B1 blocker ISA HTN Arrhythmias

Question 32

Betaxolol

Answer 32

B1 blocker Non-ISA Vasodilator of heart

Question 33

Bisoprolol

Answer 33

B1 blocker Non-ISA Great for CHF

Question 34

Carteolol

Answer 34

Beta blocker ISA Vasodilator

Question 35

Esmolol

Answer 35

``` B1 blocker Non-ISA Rapid Short duration Used peri-operative ```

Question 36

Nadolol

Answer 36

Beta blocker | Non-ISA

Question 37

Nebivolol

Answer 37

B1 blocker B3 agonist Vasodilator - NO Increase insulin

Question 38

Penbutolol

Answer 38

Beta blocker | ISA

Question 39

Pindolol

Answer 39

Beta blocker ISA No effect on renin

Question 40

Timolol

Answer 40

Beta blocker Non-ISA Ischemic heart disease

Question 41

Prazosin

Answer 41

A1 blocker SA - severe hypotension

Question 42

Doxazosin

Answer 42

A1 blocker

Question 43

Terazosin

Answer 43

A1 blocker

Question 44

Clonidine

Answer 44

A2 agonist Drug withdrawal treatment Rapid withdrawal -> rapid HTN

Question 45

Methyldopa

Answer 45

False NT | HTN in pregnancy

Question 46

Guanabenz

Answer 46

A2 agonist

Question 47

Guanfacine

Answer 47

A2 agonist

Question 48

CCB Adverse Effects

Answer 48

``` Generally well tolerated *Constipation Excessive vasodilation Edema, cough Can't use with beta blocker Can't use with ventricular function ```

Question 49

Beta blocker contraindication

Answer 49

Asthma/COPD (used B1 selective) DM Cardiac arrhthmias Shouldn't be combined with CCBs

Question 50

B2 agonist activity

Answer 50

Bradyarrhythmias and PVD