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24 Cards in this Set
- Front
- Back
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Arterial Selective Vasodilators
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Hydralazine
Minoxidil |
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Balanced Vasodilators
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Nitroprusside
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Venous Selective Vasodilators
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Nitrates
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Vasodilators
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1. Organic Nitrates (cGMP)
2. Nitroprusside (cGMP) 3. Hydralazine (cGMP) 4. Minoxidil (K+ channel activation) 5. Nerisitide 6. Beta2-AR Agonists (PDE inh) |
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Hydralazine MOA
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Reduce afterload by decreasing peripheral vascular resistance
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BiDil ingredients
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Isosorbide dinitrate & Hydralazine
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Hydralazine therapy results in what two reflex actions by the body
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Reflex tachycardia (blocked by beta blockers)
Inc fluid retention (alleviated by diuretics) |
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Hydralazine side effects
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Genetic: Slow N-acetylation can produce lupus-like syndrome
Vasodilator: headache & tachycardia |
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Minoxidil MOA
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Stimulates outward K+ Channel to hyperopolarize vascular smooth muscle
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Minoxidil use
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Reserved for moderate to severe HTN
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Minoxidil side effects
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Typical arterial vasodilator side effects
Hair growth |
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Sodium Nitroprusside MOA
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Breaks down to yield NO --> guanylate cyclase activation --> decrease in preload and afterload that inc CO & dec pulm congestion
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Inconveniences of Nitroprusside
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Infusion after reconstitution
Unstable Light sensitive Short half life |
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Nitroprusside Side Effects
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Hypotension and typical vasodil
Tolerance Metabolized to cyanide and thiocyanate, so cyanide poisoning possible |
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Nesiritide MOA
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hBNP
Stimulates guanylate cyclase & inc vascular cGMP --> arterial and venous dilation |
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Nesiritide Side Effects
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Prolonged hypotension
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Cardiac Glycoside MOA
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Inhibit Na/K ATPase
Inc intracellular Na Inc in intracellular Ca (pos inotropic action) |
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Cardiac Glycoside Electrophysiologic activity
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Penetrates carotid arch and baroreceptors --> inc sensitivity --> inc vagal outflow to pacemakers
Slow AV --> SA conduction |
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Cardiac Glycoside Use
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Inotropic support for failing heart
Afib Supraventricular tachyarrhythmias |
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Cardiac Glycoside Pharmacokinetics
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Average half life 1.5-2 days
Renal excretion |
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Cardiac Glycoside Toxicity
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Nausea, vomiting
Visual disturbances Arrhythmias |
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Cardiac Glycoside Toxicity Treatment
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Potassium
Lidocaine Atropine Fab Fragments |
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Cardiac Glycoside Drug Interactions
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Cholestyramine - dec absorption
Amiodarone, Verapamil - dec renal clearance Loop or Thiazide diuretic - hypokalemia Quinidine - dec renal clearance |
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Cardiac Glycoside Response Modifiers
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Hypokalemia
Age Hypoxia |
