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10 Cards in this Set
- Front
- Back
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What are the methods for relaxing vascular smooth mm?
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1) ↓ intracellular Ca+ --> reduce MLCK activity
2) ↑ cGMP --> ↑ dephos of MLC to prevent interaction of myosin w actin 3) stabilize membrane by ↑ K+ permeability --> prevents activation of voltage gated Ca++ channels 4) ↑cAMP --> ↑ rt of inactication of MLCK (not used due to effects on heart) |
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How do organic nitrates work?
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release NO @ target tissues --> NO activates guanylate cyclase --> ↑cGMP
major effect: VENOdiliation |
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Administration of organic nitrates
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Extensive 1st pass hepatic metabolism = low bioavailability
Must use SL, buccal, IV Acute effects and HIGH TOLERANCE take sitting to prevent syncope |
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verapamil
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Ca channel blocker
negative ionotrope/chronotrope AND decreases arterial tone |
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diltiazem
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Ca channel blocker
negative ionotrope/chronotrope AND decreases arterial tone |
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dihydrpyridines (nifedipine)
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Ca channel blocker
decreases arterial tone (only)--MOST SELECTIVE DRUG FOR THIS |
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Side effects of Ca channel blockers
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1) hypotension
2) decreased cardiac contractility 3) bradycardia (verapamil, dilteazam) |
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Contraindication of Ca channel blockers
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1) SSS
2) AV nodal dz 3) heart failure 4) use with care w/pt on B-blockers |
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Ranolazine
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Reduces intracellular Ca+ by inhibiting Na/Ca pump (indirectly)
Last line treatment |
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Treatment of unstable angina
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Primary goal: reduce O2 demand
--bed rest --B blockers --antiplatlet/anticoag therapy CCBs & fibrinolytics INEFFECTIVE |
