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48 Cards in this Set

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Short acting nitrates
amyl nitrate (inhaled)
nitroglycerin
isosorbide dinitrate
inhaled short acting nitrate
amyl nitrate
reason for using inhaled or sublingual nitrates
avoid first past hepatic metabolism
mechanism of action for nitrates
NO activates guanylyl cyclas which lowers Ca and causes relaxation
NO preferentially dilates which vessels
veins>>arteries>>arterioles
when can nitrates dilate large arteries aand decreases BP
when given at high doses
Reflex to NO
catecholamine release to increase HR and contractility

increse Renin/Ang system
How long must a person wait to take Viagra after taking nitrates
6 hours
Nitrates effects beyond vasodilation
Decrease platelet aggregation (though no effect on acute MI)

Converst Hb to metHb which sequesters CN
Uses for nitrates
Angina (stable, variant and unstable)
Toxicities of nitrates
Reflex increase in HR, contractility
Postural Hypotension
Throbbing headache
Tolerance (reversible after 8/12 hours off)
Mechanism of nitrate tolerace
exhaust tissue thiols necessary to convert NO2 to NO
Calcium channel blockers
verapamil
Diltiazem
Nimodipine
Nifedipin
Nifedipine sustained release
Isradipine
Amlodipine
Ca blocker without high first pass metabolism
amlodipine
amlodipine differs from other Ca blockers because?
it does not have a high first pass metabolsim
Ca blockers that can be given IV
verapimil
diltiazem
phenylalkylamines
verapamil
benzothiazepines
Diltiazem
Dihydropyridines
Nimodipine
Nifedipine
Isradipine
Amlodipine
preferential dilate of Ca channel blockers
arterioles>arteries>>veins
selective for cerebral blood vessels
Nimodipine
special use for Nimodipine
cerebral vasospasm
these drugs do not show a reflex response
Ca channel blockers
Ca channel blockers effect on kidneys
Increase RBF, GFR
Decrease sodium reabsorption

May worse proteinuria
May worse proteinuria
Ca channel blockers
Verapamil
Diltiazem
Nimodipine
Nifedipine
Isradipine
Amlodipine
Ca channel blockers effect on heart
decrease contractility
decrease rate
decrease AV node conduction
Uses for Ca channel blockers
Angina
HTX
Cardiac arrythmias
Vasospasm
Multidrug resistance
These two Ca channel blockers block cardia Ca channels
Verapamil
Diltiazem

Bind in open-state
May block cardiac Na channels
Verapamil
Uses for spraventricular tachyarrhytmias
Diltiazepam
Verapamil
Used to increase diastolic filling time
Verapamil
Diltiazem
uses for cerebral vasospams
Nimodipine
used to block chemo drug transmport out of cells
Verapamil
multi drug transporter blocked by verapamil
P170
Toxicities of nonDHPs
cardiac arrest
bradycardia
AV block
heart failure
mild Ca channel toxicities
headaches, nausea, flusshing, constipation, dizziness, peripheral edema
hydralazine is used in combination with?
beta blockers for sever hypertension
when used with beta block, cause relieve sever hyptertension
hydralazine
Your pateint begins having joint paint, muscle pain and a skin rash after receiving blood pressure medicine. Which one did she receive?
hydralazine
toxicities of hydralazine
arthralgia, myalgia, lupus like skin rash (10%)
site of action for minoxidil
dilates arterioles, not veins
mechanism of action for minoxidil
open K channels and hyperpolarizes muscle
minoxidil is a prodrug for what active component
minoxidil sulfate
side effects of minoxidil
hypotension
reflex response
hirsuitism
site of action for Sodium nitroprusside
arteries and veins
mechanism of action for sodium nitroprusside
generates NO to dilate veins with little reflex tachy
side effects of sodium nitroprusside
hypotension
generation of CN
uses for sodium nitroprusside
HTX emergencies and severe cardia failure