directly relax smooth muscle in arterioles and veins; causing vasodilation
Vasodilators MOA?
baroreceptor/SNS activation increase HR/CO; water retention via RAAS
What are compensatory events that occur with Vasodilators? (2)
intracellular concentration concentration of Ca++
Contraction of Vascular Smooth Muscle depends on the free ____________.
d
What type of calcium channels are found in smooth muscle?
a) N-Type
b) T-Type
c) M-type
d) L-type
decrease in sinus node pacemaker rate; decrease in AV node conduction velocity
How do Calcium Channel Blockers (CCB) reduce the contractility of the heart? (2)
long-acting muscle relaxation
How do Calcium Channel Blockers (CCB) affect smooth muscle?
arterioles; orthostatic hypotension
_______ are more sensitive than veins. Therefore ________ is not a common AE.
a
Which has a greater effect on the VSM?
a) dihydropyridines
b) non-DHPs
b
Which decreases VSM and rate/contractility of the heart?
a) dihydropyridines
b) non-DHPs
b
If _______ were given with a beta blocker would further magnify the negative inotropic effects; Contraindicated
a) dihydropyridines
b) non-DHPs
-pine suffix
How can we tell our DHPs apart?
diltiazem, verapamil
What are the Non-DHPs? (2)
a
Which can actually cause an increase in heart rate due to sympathetic reflex?
a) dihydropyridines
b) non-DHPs
can block tachycardias; short half-life, not good for HTN
What are the Pros/Cons associated with non-DHPs?
peripheral edema, reflex tachycardia
AE's of DHPs? (2)
bradycardia, av node block, depressed contractility
AE's of non-DHPs?
reduced reflex responses
Why are Long-acting DHPs safer than normal DHPs?
c
Constipation is common with _______.
a) amlodipine
b) felodipine
c) verapamil
d) dilitazem
interferes with calcium metabolism and movement across membranes; decreasing intracellular Ca++ release
Hydralazine MOA?
with nitrates in HF patients, African Americans w resistant HTN, severe HTN in pregnancy
When is Hydralazine useful? (3)
a,c
Which decreases arteriole contraction?
a) hydralazine
b) sodium nitroprusside
c) minoxidil
d) amlodipine
a
Which experiences a high first-pass metabolism with low-bioavailability?
a) hydralazine
b) sodium nitroprusside
c) minoxidil
d) amlodipine
a
Which can cause drug-induced lupus?
a) hydralazine
b) sodium nitroprusside
c) minoxidil
d) amlodipine
c
Which one is a prodrug?
a) hydralazine
b) sodium nitroprusside
c) minoxidil
d) amlodipine
c
Which one must be used with a B-Blocker AND Diuretic?
a) hydralazine
b) sodium nitroprusside
c) minoxidil
d) amlodipine
opens K+ channels on smooth muscle membrane to stabilize resting membrane potential and decrease contraction
minoxodil moa?
b
Which is used for hypertensive emergencies and HF?
a) hydralazine
b) sodium nitroprusside
c) minoxidil
d) amlodipine
b
Which dilates arterial and venous vessels?
a) hydralazine
b) sodium nitroprusside
c) minoxidil
d) amlodipine
b
Which releases Nitric Oxide?
a) hydralazine
b) sodium nitroprusside
c) minoxidil
d) amlodipine
sodium nitroprusside
-activates guanylyl cyclase; increasing the amount of cGMP
b
Which has NO compensatory increase in CO?
a) hydralazine
b) sodium nitroprusside
c) minoxidil
d) amlodipine
c
Which has the greatest compensatory increase in CO?
a) hydralazine
b) sodium nitroprusside
c) minoxidil
d) amlodipine
b
Which is given IV because it is short-acting?
a) hydralazine
b) sodium nitroprusside
c) minoxidil
d) amlodipine
excessive bp lowering, accumulation of cyanide
AE's of sodium nitroprusside? (2)
sodium thiosulfate
What can we give to counter-act cyanide when giving Sodium Nitroprusside?
bradycardia, conduction defections, HF via systolic dysfunction
What are the Contraindications of DHPs/non-DHPs? (3)
a
Which blocks calcium channels?
a) nifedipine
b) hydralazine
c) minoxodil
d) nitroprusside/ nitrates
b
Which decreases intracellular calcium levels?
a) nifedipine
b) hydralazine
c) minoxodil
d) nitroprusside/ nitrates
c
Which causes hyperpolarization through the opening of potassium channels?
a) nifedipine
b) hydralazine
c) minoxodil
d) nitroprusside/ nitrates
d
Which causes the release of nitric oxide?
a) nifedipine
b) hydralazine
c) minoxodil
d) nitroprusside/ nitrates