3Rd Pharmacology Exam - Vasodilators Cardiac Drugs

Front 1

name types of vasodilator drugs?

Back 1

ACE-inhibitors (enalapril), Nitrovasodilators (nitroglycerin), a1-Adrenergic Blockers (prazosin), Direct-acting (hydralazine), Calcium-channel blockers (amlodipine), Centrally-acting antihypertensive drugs (clonidine)

Front 2

what do vasodilators do?

Back 2

reduce afterload by dilates aa and/or reduce preload (dilate vv)

Front 3

what is the goal of preload reduction?

Back 3

reduce volume presented to left heart prior to contraction

Front 4

what disease does reduction of preload treat?

Back 4

pulmonary edema secondary to heart failure

Front 5

what drugs reduce preload?

Back 5

nitroglycerin, ACE-inhibitors, diuretics

Front 6

what is the goal of afterload reduction?

Back 6

reduce the force that opposes ventricular ejection

Front 7

what diseases does reduction of afterload treat?

Back 7

mitral valve insufficiency, congestive heart failure, cardiomyopathy

Front 8

what drugs reduce afterload?

Back 8

prazosin, ACE-inhibitors, hydralazine, calcium-channel blockers

Front 9

what are the uses of vasodilator drugs in dogs?

Back 9

hypertension, vasculitis, heart failure

Front 10

what are the uses of vasodilator drugs in cats?

Back 10

hypertension, renal disease, urethral spasm, heart failure

Front 11

what are the uses of vasodilator drugs in horses?

Back 11

navicular disease, laminitis

Front 12

what are the uses of vasodilator drugs in humans?

Back 12

heart failure, hypertension, urethral spasm

Front 13

a-Adrenergic blockers are also known as?

Back 13

sympatholytic Drugs

Front 14

name sympatholytic drugs (a-adrenergic blockers) and the receptors they block?

Back 14

phenoxybenzamine (a1, a2), prazosin (a1ab), terazonsin (a1ab), doxazonsin (a1ab), alfuzosin (a1ab), tamsulosin (a1a), silodosin (a1a)

Front 15

what are the direct effects of a-adrenergic blockers?

Back 15

block adrenergic stimulation of a1-receptors (relax vascular smooth muscle), a1-selective drugs (produce less tachycardia)

Front 16

what is the side effect of a-adrenergic blockers?

Back 16

hypotension

Front 17

what are a1-antagonists used for?

Back 17

non-cardiac uses (tamsulosin and silodosin)

Front 18

what chemical are nitrovasodilators?

Back 18

organic nitrates; esters of nitrous acid

Front 19

what are the direct effects of nitrovasodilators?

Back 19

organic nitrates, nitrogen esters, prodrugs that generate NO, which stimulates active guanylate cyclase increasing cyclic-GMP relaxes vascular smooth muscle

Front 20

name and briefly describe nitrovasodilators?

Back 20

nitroglycerin (glyceryl trinitrate- well-absorbed, high 1st-pass effects, active metabolites), isosorbide dinitrate (well-absorbed, high 1st-pass effects, active metabolites-mononitrate), isosorbide mononitrate (orally bioavailable), amyl nitrate (usually inhales - easily vaporized)

Front 21

what are the clinical uses of nitrate vasodilators?

Back 21

angina pectors (humans), reduce preload, reduce pulmonary congestion

Front 22

what are the possible formulations of nitrate vasodilators?

Back 22

ointments, transdermal patches, sublingual tablets

Front 23

what is interesting about the pharmacokintetics of nitrate vasodilators?

Back 23

high first pass effects

Front 24

what are the adverse effects of nitrate vasodilators?

Back 24

hypotension & tolerance with frequent use

Front 25

name ACE-inhibitors?

Back 25

captopril, enalapril, benazepril, lisinopril, fosinopril, moexipril, trandolapril, ramipril, quinapril

Front 26

what does angiotensin II cause?

Back 26

alsdosterone secretion (Na+ & water retention) & vasoconstriction (increases peripheral resistance)

Front 27

what are the effects of angiotensin II?

Back 27

stimulates arginine vasopressin, increased sympathetic tone (NE release), increased peripheral resistance, secretions of aldosterone, cardiotoxic effects (myocardilal remodeling)

Front 28

what are the direct effects of ACE-inhibitors?

Back 28

inhibit formation of angiotensin II, inhibit secretion of aldosterone (decreases congestion), decreases sympathetic tone (inhibits chronic effects of catecholamines), decreases degradation of bradykinin (balanced vasodilation)

Front 29

what are the clinical benefits of ACE-inhibitors?

Back 29

decrease vascular resistance and increase cardiac output, decrease pulmonary edema and ascites

Front 30

what are the clinical uses of ACE-inhibitors?

Back 30

heart failure (cats, dogs, horses), hypertension (cats, dogs), improve survival in dogs with cardiomyopathy and congestive heart failure, renal disease

Front 31

what beneficial effects do ACE-inhibitors produce in animals with chronic renal failure?

Back 31

decreased glomerular pressure, decreased proteinuria, decreased glomerular sclerosis

Front 32

what are the risks of ACE-inhibitors on kidneys?

Back 32

decreased filtration pressure may cause azotemia, risk of acute renal failure increases in patients (diuretic therapy, decreased renal perfusion), no adverse effects during long-term treatment of CHF in dogs with enalapril

Front 33

what are the adverse effects of ACE-inhibitors?

Back 33

hypotension (dose related), decreased renal perfusion (azotemia), electrolyte imbalance (Na+/K+), complications with diuretics, coughing and angioedema (people)

Front 34

what are the drug interactions with ACE-inhibitors?

Back 34

potentiates diuretic drugs, NSAIDs (via their antiprostaglandin action) may decrease efficacy, spironolactone- may act synergistically to inhibit aldosterone

Front 35

name angiotensin II receptor antagonists?

Back 35

losartan, candesartn cilexetil, valsartan, eprosartan, irbesartan, telmisartan

Front 36

what are the direct affects of the angiotensin-II receptor blockers?

Back 36

direct inhibitors of the angiotensin II recetor

Front 37

how do angiotensin II receptor blockers compare to ACE-inhibitors?

Back 37

fewer side effects

Front 38

what are the types of calcium-channel blocking drugs?

Back 38

nondihydropyridines and dihydropyridines

Front 39

name the nondihydropyridine Calcium-channel blockers?

Back 39

diltiazem, verapamil

Front 40

name the dihydropyridine Calcium-channel blockers?

Back 40

amlodipine, felodipine, nicardipine, nifedipine

Front 41

what are the direct affects of the calcium-channel blocking drugs?

Back 41

block inward movement of calcium in voltage-dependent calcium channels

Front 42

what are the direct affects of the nondihydropyridine Ca++ channel blocking drugs?

Back 42

block L-type Ca++ channels & slow cardiac nodal conduction

Front 43

what are the direct affects of the dihydropyridine Ca++ channel blocking drugs?

Back 43

block L-type Ca++ channels, relax vascular smooth muscle, vasodilators

Front 44

what is the clinical use of calcium-channel blocking drugs?

Back 44

vasodilators; treat hypertensive syndromes in dogs, cats, horses & reduce preload and afterload in heart failure

Front 45

how is amlodipine used in cats?

Back 45

treatment of hypertension associated with renal disease, endocrine disease (hyperthyroidism), diabetes mellitus

Front 46

how is isoxsuprine used?

Back 46

vasodilator used in horses for navicular disease

Front 47

how is minoxidil used?

Back 47

potent vasodilator; stimulates hair growth topically

Front 48

name a phosphodiesterase-V inhibitor?

Back 48

sildenafil

Front 49

how is sildenafil used?

Back 49

relaxes vesels in the corpora cavernosa and pulmonary circulation, increases c-GMP by inhibiting phosphodiesterase V