Science Medicine PrepU Chapter 55 PrepU
Chapter 55
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can use ___ for hypertensive emergencies
vasodilators
what can dilate both arteries and veins
nitroprusside and nitrates
what is the body's response to vasodilation and hypotension
-sympathetic stimulation of the heart -> increased contraction, HR, oxygen consumption
-increases renin -> sodium and water retention
vasodilators are often given with ___ and/or ___ to counteract compensatory mechanisms
beta blockers, diuretic
hydralazine MOA
inhibit Ca release from SR in smooth muscle and release NO -> vasodilation
hydralazine is a ___ arteriole vasodilator
%
direct
therapeutic effects of hydralazine
vasodilation -> decreased peripheral resistant, decreased BP
adverse effects of hydralazine
N/HA, anorexia, palpitations, sweating, flushing, tachycardia
hydralazine can precipitate ___ and can cause ___ at really high doses
angina, lupus like syndrome
when to avoid hydralazine
CAD, mitral valve rheumatic heart disease
MOA of minoxidil
opens ATP sensitive K channel in smooth muscle -> hyperpolarization -> voltage gated Ca channels
close -> vasodilation -> decreased BP
adverse effects of minoxidil
tachycardia, palpitations, angina, edema, sweating, hypertrichosis
MOA of sodium nitroprusside
nitric oxide stimulates guanylyl cyclase -> increased cGMP -> dephosphorylation of myosin light chain
-> vasodilation of arteries and veins
sodium nitroprusside decreases BP ____
rapidly
how is sodium nitroprusside administered
, slow IV infusion
sodium nitroprusside is sensitive to ___
light
sodium nitroprusside requires continuous monitoring of ___
BP
adverse effects of sodium nitroprusside
hypotension, cyanide accumulation
prophylaxis for cyanide poisoning when giving sodium nitroprussine
sodium thiosulfate
MOA of fenoldopam
activates dopamine receptors in CNS -> activates adenylyl cyclase -> increases cAMP -> vasodilation
therapeutic effects of fenoldopam
increased renal blood flow -> natriuresis, diuresis
when is fenoldopam useful
rapid BO reduction
adverse effects of fenoldopam
tachycardia, HA, flushing, increased intraocular pressure
MOA of beta blockers
antagonize beta receptors -> decrease HR and contractility -> decrease CO -> decrease BP
beta blockers decrease ___ demand
oxygen
%
beta blockers prolong ___ creating an ___ effect
atrial refractory period, antiarrhythmia
beta blockers have inhibitors effects on the ___ system
sympathetic nervous
beta blockers decrease ___ secretion
renin
nonselective beta blocker cardio effects
decrease CO, workload, oxygen consumption, slow arrhythmias
nonselective beta blocker pulmonary effects
bronchoconstriction
uses for nonselective beta blockers
HTN with compelling indications, angina, MI, migraine, hyperthyroidism
adverse effects of nonselective beta blockers
bronchoconstriction, arrhythmias, sexual impairment, fatigue
selective beta blockers are selective in ___ doses
low
selective beta blockers minimize ___
bronchoconstriction
what are the two most common selestive beta blockers
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