Cardio- Lecture (Steiner) Vasolidators

Front 1

vasodilator drugs

hydralazine

Back 1

Absorbed in the GI tract.

Acts on arterioles.

Does not act on coronaries and veins.

T1/2: 1-3 h (it can be used in the chronic therapy of hypertension)

Front 2

hydralazine MOA

Back 2

Don’t know
Decrease cytosolic calcium levels so have less contraction

Front 3

hydralazine adverse effects

Vasodilation-associated adverse effects

Back 3

Excessive blood pressure drop

Flushing

Dizziness, nausea & headache

Tachycardia & palpitations (compensatory response)

Sodium retention and edema (compensatory response

Front 4

hydralazine adverse effects

Immunological reactions (off-target side effect

Back 4

With high dosages (>400 mg/day), there is a 10-20% incidence of a syndrome characterized by:

Arthalgia (joint pain);
Myalgia (muscle pain);
Skin rashes;
Fever;

Such syndrome resembles lupus erythematosus.

Front 5

hydralazine

orally active?

Back 5

yesq

Front 6

hydralazine

vascular beds affected

Back 6

arterioles

Front 7

hydralazine

MOA

Back 7

unknown but ultimately reduces Ca++

Front 8

minoxidil

Back 8

Absorbed in the GI tract.

Pro-drug
sulfated after going to liver to become a vasodilator

Dilates arterioles.

No action on veins or coronaries.

T1/2: 4 h (it can be used in the chronic therapy of hypertension)

Front 9

minoxidil
adverse effects:
Vasodilation-associated adverse effects

Back 9

Dizziness, nausea & headache

Tachycardia & palpitations (compensatory response)

Sodium retention and edema (compensatory response)

Front 10

minoxidil

adverse effects
angina (like hydralazine)

Back 10

see notes

Front 11

is tachycardia an adverse event?

Back 11

yes

Front 12

minoxidil

alternate use
correction of baldness

Back 12

Topical minoxidil (Rogaine) is used as a stimulant to hair growth.

topical --not systemic

Front 13

minoxidil

orally active?

Back 13

yes

Front 14

minoxidil

vascular bed effected

Back 14

arterioles

Front 15

minoxidil

MOA

Back 15

opens K+ channel

Front 16

sodium nitroprusside

Back 16

Decomposes under intestinal alkaline conditions (has to be administered IV).

T1/2: 1-2 min (needs to be continuously infused).

Acts on arterioles, veins, and coronaries.

Exists as a salt (sodium, is the highest conc in extracellular fluid- not enough to increase BP)

Front 17

sodium nitroprusside

indications

Back 17

Treatment option for hypertensive emergencies.

Not indicated for chronic therapy of hypertension

Front 18

sodium nitroprusside can easily pass the membrane so nitric oxide gets into smooth muscle cells quickly.

Back 18

true

Front 19

sodium nitroprusside adverse effects

Back 19

Excessive vasodilation and consequent hypotension

** must be monitored closely **

Front 20

sodium nitroprusside adverse effects

uncommon

Back 20

cyanide intoxification

Cyanide is a byproduct of nitroprusside breakdown
Cyanide might accumulate in the body

Front 21

sodium nitroprusside

orally active

Back 21

yes

Front 22

sodium nitroprusside

vascular beds affected

Back 22

arterioles
veins
coronaries

Front 23

sodium nitroprusside

MOA

Back 23

release nitric oxide

Front 24

verapamil

Back 24

Absorbed in the GI tract.
Acts on arterioles & coronaries.
Weak effect on veins.
T1/2: 4-6 h

Front 25

verapamil

indication

Back 25

the chronic therapy of hypertension

Front 26

verapamil

MOA

Back 26

blocks the calcium channel
(smooth muscle cell)
decreased calcium- decreased contraction

Front 27

verapamil effects what channel?

Back 27

L channel

Front 28

location of L channel

Back 28

smooth muscle
cardiac muscle

Front 29

properties of L channel

Back 29

long duration
large current
high threshold

Front 30

L channel antagonists

Back 30

verapamil
dihydropyridines

Front 31

verapamil adverse effects

Vasodilation-associated adverse effects

Back 31

Hypotension

Skin flushing

Dizziness, nausea & headache

Sodium retention and edema (compensatory response)
Minimal compared to other vasodilators

Front 32

verapamil adverse effects

Bradycardia and even asystole (rare but serious

Back 32

decreased SA-AV node activity (decreased HR)
contraction force (decreased SV)

Front 33

verapamil adverse effects

constipation

Back 33

Adverse effect likely reflects inhibition of Ca2+ channels in smooth muscle cells of the GI tract

Front 34

verapamil

orally active

Back 34

yes

Front 35

verapamil

vascular beds affected

Back 35

arterioles and coronaries

Front 36

verapamil

MOA

Back 36

blocks L type calcium channels

Front 37

other L-type calcium channel blockers

diltiazem
dihydropyridines (nifedipine)
orally active?

Back 37

yes