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48 Cards in this Set
- Front
- Back
Short acting nitrates
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amyl nitrate (inhaled)
nitroglycerin isosorbide dinitrate |
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inhaled short acting nitrate
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amyl nitrate
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reason for using inhaled or sublingual nitrates
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avoid first past hepatic metabolism
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mechanism of action for nitrates
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NO activates guanylyl cyclas which lowers Ca and causes relaxation
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NO preferentially dilates which vessels
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veins>>arteries>>arterioles
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when can nitrates dilate large arteries aand decreases BP
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when given at high doses
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Reflex to NO
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catecholamine release to increase HR and contractility
increse Renin/Ang system |
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How long must a person wait to take Viagra after taking nitrates
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6 hours
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Nitrates effects beyond vasodilation
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Decrease platelet aggregation (though no effect on acute MI)
Converst Hb to metHb which sequesters CN |
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Uses for nitrates
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Angina (stable, variant and unstable)
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Toxicities of nitrates
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Reflex increase in HR, contractility
Postural Hypotension Throbbing headache Tolerance (reversible after 8/12 hours off) |
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Mechanism of nitrate tolerace
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exhaust tissue thiols necessary to convert NO2 to NO
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Calcium channel blockers
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verapamil
Diltiazem Nimodipine Nifedipin Nifedipine sustained release Isradipine Amlodipine |
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Ca blocker without high first pass metabolism
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amlodipine
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amlodipine differs from other Ca blockers because?
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it does not have a high first pass metabolsim
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Ca blockers that can be given IV
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verapimil
diltiazem |
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phenylalkylamines
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verapamil
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benzothiazepines
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Diltiazem
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Dihydropyridines
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Nimodipine
Nifedipine Isradipine Amlodipine |
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preferential dilate of Ca channel blockers
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arterioles>arteries>>veins
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selective for cerebral blood vessels
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Nimodipine
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special use for Nimodipine
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cerebral vasospasm
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these drugs do not show a reflex response
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Ca channel blockers
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Ca channel blockers effect on kidneys
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Increase RBF, GFR
Decrease sodium reabsorption May worse proteinuria |
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May worse proteinuria
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Ca channel blockers
Verapamil Diltiazem Nimodipine Nifedipine Isradipine Amlodipine |
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Ca channel blockers effect on heart
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decrease contractility
decrease rate decrease AV node conduction |
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Uses for Ca channel blockers
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Angina
HTX Cardiac arrythmias Vasospasm Multidrug resistance |
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These two Ca channel blockers block cardia Ca channels
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Verapamil
Diltiazem Bind in open-state |
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May block cardiac Na channels
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Verapamil
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Uses for spraventricular tachyarrhytmias
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Diltiazepam
Verapamil |
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Used to increase diastolic filling time
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Verapamil
Diltiazem |
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uses for cerebral vasospams
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Nimodipine
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used to block chemo drug transmport out of cells
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Verapamil
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multi drug transporter blocked by verapamil
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P170
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Toxicities of nonDHPs
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cardiac arrest
bradycardia AV block heart failure |
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mild Ca channel toxicities
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headaches, nausea, flusshing, constipation, dizziness, peripheral edema
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hydralazine is used in combination with?
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beta blockers for sever hypertension
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when used with beta block, cause relieve sever hyptertension
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hydralazine
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Your pateint begins having joint paint, muscle pain and a skin rash after receiving blood pressure medicine. Which one did she receive?
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hydralazine
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toxicities of hydralazine
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arthralgia, myalgia, lupus like skin rash (10%)
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site of action for minoxidil
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dilates arterioles, not veins
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mechanism of action for minoxidil
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open K channels and hyperpolarizes muscle
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minoxidil is a prodrug for what active component
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minoxidil sulfate
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side effects of minoxidil
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hypotension
reflex response hirsuitism |
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site of action for Sodium nitroprusside
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arteries and veins
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mechanism of action for sodium nitroprusside
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generates NO to dilate veins with little reflex tachy
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side effects of sodium nitroprusside
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hypotension
generation of CN |
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uses for sodium nitroprusside
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HTX emergencies and severe cardia failure
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