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Flashcards in Vasodilating Drugs Deck (49)
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1

sodium nitroprusside

vasodilator --> spontaneous nonenzymatic NO release
nonspecific - dilates arteries AND veins (decrease afterload and preload)
HTN emergencies --> fast acting but toxicity limits use
**can cause cyanide accumulation --> NOT for patients with renal issues

2

what is the toxicity associated with sodium nitroprusside?

cyanide accumulation (-->cyanide-->thiocyanate --> kidneys)
can cause acid/base issues, arrhythmias, death
DO NOT USE WITH RENAL ISSUES

3

minoxidil

vasodilator, K+ channel opener
hyperpolarization causes arteriolar smooth m relaxation
doesnt affect veins
coadminister with B blocker to avoid reflex
BUT can evoke sympathetic reflex (increase HR, renin, contractility)

4

Rogaine

topical minoxidil
minoxidil, a K+ channel opener, increases hair growth
can have CV effects

5

what drug opens K+ channels?

minoxidil

6

hydralazine

oral
directly vasodilates smooth m arterioles
decreases TPR (afterload) and BP
can cause sympathetic relfex(HR increase, renin retention)
Use with pregnancy HTN

7

drug for HTN associated with pregnancy?

hydralazine

8

clonidine

CNS central acting vasodilator (sympathoLYTIC)
stimulates alpha2A receptor in brainstem to decrease sympathetic outflow!
BUT high doses reverse the effect --> activate alpha 2B on vascular smooth m and cause vasoconstriction

9

what happens with high doses of clonidine?

lose dilation effect
activates alpha 2B receptor in smooth m which causes vasoconstriction

10

alpha 2A vs alpha 2B receptors

2A is in CNS and causes vasodilation(decrease sympathetic)
2B is in vascular smooth m and vasoconstricts

11

guanadrel

false neurotransmitter that is inactive at postganglionic adrenergic receptors
taken up by NE transporter and replaces NE in vesicles
BUT there is potential for NE release so DONT USE WITH pheochromocytoma

12

risk of guanadrel?

since it is a false neurotransmitter there is a chance NE could be released

13

reserpine

binds to storage vesicles in CNS and PNS and inhibits transport and storage of NE/dopa

14

categories of ca channel blockers

dihydropyridine
non-dihydropyridine

15

vasodilating dihydropyridine? and nondihydropyridine?

di- nifedipine
non-verapamil

16

ca ch blockers (dihydro/nondihydro) effects

both act on smooth m (artery>venous) AND myocardium
inhibit L-type Ca channels
decreases contractility and Sa rate/av conductivity
dont affect skeletal muscle

17

verapamil

nondihydropyridine
L type ca ch blocker , affects vessels and heart
vasodilates vessels
decreases SA rate and AV conduction velocity
use: HTN and arrythmias
BUT can cause ecessive vasodilation, ,AV node block, and decreased CO

18

T/F: verapamil only affects smooth m?

FALSE
it affects vessels AND myocardium (SA rate and AV conduction v)

19

nifedipine

dihydropyridine
L type ca ch blocker, smooth m and myocardium
keeps intracellular Ca LOW
reflex causes increase in HR and contractility
use with heart failure

20

which to use with heart failure: nifedipine or verapamil

nifedipine due to reflex
verapamil can cause excess dilation and AV node block/decreased CO

21

PDE inhibitors

phosphodiesterase inhibitors
prevent hydrolysis of cAMP or cGMP to their inactive form -->increased cAMP = + inotropism of heart
vasodilation! = 'inodilators'
2 drugs = theophylline and sildenafil
can cause thrombocytopenia/ increase in mortality?

22

what category can cause thrombocytopenia?

PDE inhibitors

23

sildenafil

PDE inhibitor, prevents breakdown of cGMP --> dilation and decrease preload/afterload = +inotropism
selective for PDE5(cGMP) which is in penile, retina, and vasculature
treat: erectile dysfunction

24

what drug treats erectile disfunction?

sildenafil

25

nitroglycerin

organic nitrate used to vasodilate (release NO)
treat: angina, HTN, ischemia, after coronary bypass
venous dilation(>artery)

26

after a coronary bypass, give the patient...

nitroglycerin

27

phentolamine

nonselective alpha blocker, vasodilates
use for patients with catecholamine emergencies

28

esmolol

B blocker, vasodilates
use: aortic dissection and postop HTN

29

vasodilator to treat after aortic dissection?

esmolol

30

vasodilator for postop HTN?

esmolol