Vasodilators in ADHF

Question 1

Vasodilator benefit in ADHF

Answer 1

increase venous capacitance, resulting in lower preload to reduce myocardial stress.
Limits ischemia and helps preserve cardiac tissue Produces rapid symptomatic benefit by reducing pulmonary congestion

Question 2

Sodium Nitroprusside MOA

Answer 2

Nitric oxide–induced stimulation of GC to convert GTP to cGMP

Question 3

Sodium Nitroprusside Clinical effects

Answer 3

Balanced arterial and venous vasodilator

Question 4

Sodium Nitroprusside Indications

Answer 4

Warm and wet ADHF, alternative to inotropes in cold and wet ADHF, hypertensive crises

Question 5

Sodium Nitroprusside Dosing in ADHF

Answer 5

0.1–1 mcg/kg/min IV

Question 6

Sodium Nitroprusside Elimination

Answer 6

Half-life < 10 min, Cyanide hepatically metabolized,
thiocyanate renally excreted (accumulation in dysfunction)

Question 7

Nitroglycerin Mechanism of action

Answer 7

Combines with sulfhydryl groups in vascular endothelium to create S-nitrosothiol compounds that mimic nitric oxide’s stimulation of GC and production of cGMP

Question 8

Nitroglycerin Clinical effects

Answer 8

Preferential venous vasodilator > arterial vasodilator, arterial vasodilation at high doses

Question 9

Nitroglycerin Indications

Answer 9

Warm and wet ADHF, ACS, or hypertensive crises

Question 10

Nitroglycerin Dosing in ADHF

Answer 10

5 -100 mcg/min, 200 mcg/min max

Question 11

Nitroglycerin Elimination

Answer 11

Half-life = 1–3 min, Inactive metabolites in urine