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19 Cards in this Set
- Front
- Back
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nitrates effect on preload
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decreases preload
increases venous capacitance which decrease filling pressure |
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nitrates are good for....
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failing hearts, angina
veins > arteries > arterioles |
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nitrates effect on afterload
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increase arteriole dilation
also increase dilation of coronary vessels |
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how do nitrates work with classic angina (obstruction of large coronary vessels)?
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they decrease stress on cardiac wall
increase cardiac perfusion decrease afterload |
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how do nitrates work on varient angina (transient spasm of coronary vessels)?
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dilate "epicardial arteries" which redistributes blood from epi --> endocardium
also prevent arterial spasm |
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what are two important nitrates?
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nitroglycerin and isosorbide dinitrate
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what are two important vasodilators?
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hydralazine and Na+ nitroprusside
PUT THE SALTY RUSSIAN ON THE WATER RALES hydralazine most important |
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What untoward effects to vasodilators have when used alone?
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barro-rec increase in HR/CO
increase in renin secretion and plasma volume |
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what is usually given with vasodilators?
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beta blockers
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what is "coronary steal"?
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may be triggered by administration of vasodilators in pts with coronary artery disease because vasodilators have no effect on coronary epicardial arteries (arteries below plaque = maximally dilated and no response, arteries above = rapid dilation which leads to mismatch and diversion of blood)
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hydralazine; usually given for what and SE?
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given for hypertension with diuretics and beta blockers; SE is lupul-like syndrom in 20% of pts and not often used
MOA unknown |
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sodium nitroprusside, MOA
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creates NO and enhances availability of cGMP
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when is Na nitroprusside used?
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in pts with severe left ventricular dysfunction to enhance CO and sometimes in hypertensive emergencies
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what makes Na nitropruss different from other arteriole vasodilators?
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modest increase in heart rate and overall decrease in cardiac oxygen comsumption
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angina, classic
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due to obstruction (coronary arteries)
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varient angina
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due to spasms (coronary arteries)
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unstable angina
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pre-MI angina (high occlusion, thrombi forming)
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digoxin, effects
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increases contractility by increasing Ca++ (CO increases, heart pumped better)
increases vagal tone (reduces transmission through the AV node |
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which drugs reduces transmission through the AV node?
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beta blockers, Ca++ channel blockers, digoxin
ABCD AV NODE, BETA BLOCKER, CA++ CHANNEL BLOCKER, DIGOXIN |
