Podcast
Questions and Answers
What is the primary action of arterial vasodilators?
What is the primary action of arterial vasodilators?
- Fluctuate peripheral resistance unpredictably
- Decrease blood pressure by reducing afterload (correct)
- Increase venous return
- Increase heart rate significantly
Which class of vasodilators is primarily used to treat acute pulmonary edema?
Which class of vasodilators is primarily used to treat acute pulmonary edema?
- Arterial dilators
- Non-selective vasodilators
- Venodilators (correct)
- Mixed dilators
What side effect is commonly associated with vasodilators due to reflex sympathetic stimulation?
What side effect is commonly associated with vasodilators due to reflex sympathetic stimulation?
- Reflex tachycardia (correct)
- Hyperkalemia
- Diarrhea
- Hypotension
How do mixed vasodilators like sodium nitroprusside and prazosin affect preload and afterload?
How do mixed vasodilators like sodium nitroprusside and prazosin affect preload and afterload?
Which adverse effect often necessitates the combination of vasodilators with diuretics?
Which adverse effect often necessitates the combination of vasodilators with diuretics?
What mechanism do vasodilators primarily use to relax vascular smooth muscle?
What mechanism do vasodilators primarily use to relax vascular smooth muscle?
What is a common characteristic of both arterial and venous vasodilators?
What is a common characteristic of both arterial and venous vasodilators?
Which of the following vasodilators primarily acts by decreasing peripheral resistance?
Which of the following vasodilators primarily acts by decreasing peripheral resistance?
What role do vasodilators play in the management of hypertension?
What role do vasodilators play in the management of hypertension?
Which drug is considered a third choice for treating hypertension in pregnancy?
Which drug is considered a third choice for treating hypertension in pregnancy?
What is a common side effect associated with hydralazine use?
What is a common side effect associated with hydralazine use?
Which mechanism describes the action of minoxidil in treating hypertension?
Which mechanism describes the action of minoxidil in treating hypertension?
Which of the following is a common practice when prescribing hydralazine?
Which of the following is a common practice when prescribing hydralazine?
Why is hydralazine often paired with beta-blockers?
Why is hydralazine often paired with beta-blockers?
What condition can develop as a side effect of long-term use of hydralazine?
What condition can develop as a side effect of long-term use of hydralazine?
How does vasodilation from minoxidil affect vascular smooth muscle?
How does vasodilation from minoxidil affect vascular smooth muscle?
What is the primary mechanism by which sodium nitroprusside exerts its action?
What is the primary mechanism by which sodium nitroprusside exerts its action?
Which of the following correctly describes the use of fenoldopam in clinical practice?
Which of the following correctly describes the use of fenoldopam in clinical practice?
What is a major concern associated with sodium nitroprusside administration?
What is a major concern associated with sodium nitroprusside administration?
Which receptors do endothelin-1 primarily act upon in vascular smooth muscle?
Which receptors do endothelin-1 primarily act upon in vascular smooth muscle?
Which drug is known to combine well with diuretics and β-blockers for the treatment of chronic hypertension?
Which drug is known to combine well with diuretics and β-blockers for the treatment of chronic hypertension?
How should sodium nitroprusside be stored prior to administration?
How should sodium nitroprusside be stored prior to administration?
What effect does diazoxide have on the vascular smooth muscle?
What effect does diazoxide have on the vascular smooth muscle?
What is the primary indication for using arterial vasodilators like sodium nitroprusside?
What is the primary indication for using arterial vasodilators like sodium nitroprusside?
What is the primary action of Bosentan in treating pulmonary hypertension?
What is the primary action of Bosentan in treating pulmonary hypertension?
Which drug is contraindicated in patients taking nitrates?
Which drug is contraindicated in patients taking nitrates?
In patients with chronic kidney disease, which is generally the best choice for antihypertensive therapy?
In patients with chronic kidney disease, which is generally the best choice for antihypertensive therapy?
What is the typical duration of effect for drugs like Sildenafil after oral administration?
What is the typical duration of effect for drugs like Sildenafil after oral administration?
Which vasodilator is primarily used for the treatment of erectile dysfunction?
Which vasodilator is primarily used for the treatment of erectile dysfunction?
For a 55-year-old patient with non-complicated hypertension, which class of antihypertensive drugs is considered the best initial choice?
For a 55-year-old patient with non-complicated hypertension, which class of antihypertensive drugs is considered the best initial choice?
What is a common side effect associated with the use of PDE type 5 inhibitors?
What is a common side effect associated with the use of PDE type 5 inhibitors?
In patients suffering from hypertension during pregnancy, which medication is typically recommended?
In patients suffering from hypertension during pregnancy, which medication is typically recommended?
Diazoxide is a potent diuretic used to treat chronic hypertension.
Diazoxide is a potent diuretic used to treat chronic hypertension.
Sodium nitroprusside, when administered, can produce cyanide and thiocyanate as metabolites.
Sodium nitroprusside, when administered, can produce cyanide and thiocyanate as metabolites.
Fenoldopam is primarily indicated for oral administration in chronic hypertension management.
Fenoldopam is primarily indicated for oral administration in chronic hypertension management.
Endothelin-1 primarily causes vasodilation when it acts on its receptors.
Endothelin-1 primarily causes vasodilation when it acts on its receptors.
The primary action of sodium nitroprusside is to increase cGMP levels, resulting in vasodilation.
The primary action of sodium nitroprusside is to increase cGMP levels, resulting in vasodilation.
Diazoxide should be used only for acute emergencies due to its high diuretic effect.
Diazoxide should be used only for acute emergencies due to its high diuretic effect.
Sodium nitroprusside must be shielded from light to prevent degradation before administration.
Sodium nitroprusside must be shielded from light to prevent degradation before administration.
The use of fenoldopam can induce vasoconstriction by stimulating D1 receptors.
The use of fenoldopam can induce vasoconstriction by stimulating D1 receptors.
The use of diuretics in combination with hydralazine is primarily to enhance its vasodilatory effect.
The use of diuretics in combination with hydralazine is primarily to enhance its vasodilatory effect.
Hydralazine may lead to systemic lupus erythematosus-like syndrome, particularly in fast acetylators.
Hydralazine may lead to systemic lupus erythematosus-like syndrome, particularly in fast acetylators.
Minoxidil acts as a vasodilator by opening K+ channels, leading to hyperpolarization of vascular smooth muscle.
Minoxidil acts as a vasodilator by opening K+ channels, leading to hyperpolarization of vascular smooth muscle.
ACEI and CCBs are considered less effective than vasodilators like hydralazine in treating hypertension.
ACEI and CCBs are considered less effective than vasodilators like hydralazine in treating hypertension.
Hydralazine is often the first-choice medication for hypertension in pregnancy.
Hydralazine is often the first-choice medication for hypertension in pregnancy.
The direct arteriodilator action of hydralazine is attributed to its effect on K+ channels.
The direct arteriodilator action of hydralazine is attributed to its effect on K+ channels.
Chronic use of hydralazine can result in a condition similar to rheumatoid arthritis.
Chronic use of hydralazine can result in a condition similar to rheumatoid arthritis.
CCBs are known for causing more adverse effects compared to newer vasodilators such as ACEIs.
CCBs are known for causing more adverse effects compared to newer vasodilators such as ACEIs.
Arterial dilators are primarily used to increase blood pressure.
Arterial dilators are primarily used to increase blood pressure.
Venous dilators primarily act by reducing preload.
Venous dilators primarily act by reducing preload.
Mixed vasodilators have no effect on both preload and afterload.
Mixed vasodilators have no effect on both preload and afterload.
Vasodilators can cause reflex sympathetic stimulation, often leading to reflex tachycardia.
Vasodilators can cause reflex sympathetic stimulation, often leading to reflex tachycardia.
Sodium nitroprusside should be combined with a diuretic to prevent sodium retention.
Sodium nitroprusside should be combined with a diuretic to prevent sodium retention.
Nifedipine is classified as a venodilator.
Nifedipine is classified as a venodilator.
Diuretics are typically not needed when prescribing vasodilators due to their mechanism of action.
Diuretics are typically not needed when prescribing vasodilators due to their mechanism of action.
Vasodilators selectively target only the smooth muscle of the arteries.
Vasodilators selectively target only the smooth muscle of the arteries.
Bosentan is a selective ETA blocker.
Bosentan is a selective ETA blocker.
Sildenafil's effect lasts for approximately 4-5 hours after administration.
Sildenafil's effect lasts for approximately 4-5 hours after administration.
Nitric oxide also increases cGMP leading to vasodilation.
Nitric oxide also increases cGMP leading to vasodilation.
ACE inhibitors are preferred for treating hypertension in diabetic patients with proteinuria.
ACE inhibitors are preferred for treating hypertension in diabetic patients with proteinuria.
Tadalafil is a phosphodiesterase (PDE) type 2 inhibitor.
Tadalafil is a phosphodiesterase (PDE) type 2 inhibitor.
Alpha-methyldopa is contraindicated for managing hypertension during pregnancy.
Alpha-methyldopa is contraindicated for managing hypertension during pregnancy.
Headache and blue discoloration of vision are common side effects of phosphodiesterase inhibitors.
Headache and blue discoloration of vision are common side effects of phosphodiesterase inhibitors.
Labetalol is used primarily for treating chronic kidney disease.
Labetalol is used primarily for treating chronic kidney disease.
What is the primary reason for the decline in the use of vasodilators like hydralazine?
What is the primary reason for the decline in the use of vasodilators like hydralazine?
Describe how hydralazine works as a vasodilator.
Describe how hydralazine works as a vasodilator.
What condition may develop as a side effect of hydralazine, particularly in slow acetylators?
What condition may develop as a side effect of hydralazine, particularly in slow acetylators?
Why is hydralazine typically combined with diuretics?
Why is hydralazine typically combined with diuretics?
What mechanism underlies the action of minoxidil in vascular smooth muscle relaxation?
What mechanism underlies the action of minoxidil in vascular smooth muscle relaxation?
What role do beta-blockers play when hydralazine is prescribed?
What role do beta-blockers play when hydralazine is prescribed?
What are the three choices of antihypertensive medications for pregnant patients?
What are the three choices of antihypertensive medications for pregnant patients?
What is a notable adverse effect of long-term hydralazine use?
What is a notable adverse effect of long-term hydralazine use?
What distinguishes ambrisentan from bosentan in terms of receptor selectivity?
What distinguishes ambrisentan from bosentan in terms of receptor selectivity?
Identify a significant contraindication for the use of PDE type 5 inhibitors.
Identify a significant contraindication for the use of PDE type 5 inhibitors.
For a patient with diabetic nephropathy, which class of antihypertensive medication is preferred?
For a patient with diabetic nephropathy, which class of antihypertensive medication is preferred?
What is the primary mechanism of action of sildenafil in treating erectile dysfunction?
What is the primary mechanism of action of sildenafil in treating erectile dysfunction?
Which drug class should be administered as the first-line treatment for uncomplicated hypertension in a 55-year-old patient?
Which drug class should be administered as the first-line treatment for uncomplicated hypertension in a 55-year-old patient?
What are common side effects associated with PDE type 5 inhibitors?
What are common side effects associated with PDE type 5 inhibitors?
What treatment is commonly recommended for hypertension during pregnancy?
What treatment is commonly recommended for hypertension during pregnancy?
Describe the impact of sildenafil's onset time and duration of action upon administration.
Describe the impact of sildenafil's onset time and duration of action upon administration.
What is the mechanism by which sodium nitroprusside achieves vasodilation?
What is the mechanism by which sodium nitroprusside achieves vasodilation?
Why should sodium nitroprusside be protected from light before administration?
Why should sodium nitroprusside be protected from light before administration?
How does fenoldopam specifically act on peripheral dopamine receptors and what is the result?
How does fenoldopam specifically act on peripheral dopamine receptors and what is the result?
What role do endothelin-1 receptor antagonists play in vascular function?
What role do endothelin-1 receptor antagonists play in vascular function?
What is a significant risk associated with the administration of sodium nitroprusside?
What is a significant risk associated with the administration of sodium nitroprusside?
What is the clinical application of diazoxide in the context of hypertension?
What is the clinical application of diazoxide in the context of hypertension?
Explain how sodium nitroprusside affects both arterial and venous dilation.
Explain how sodium nitroprusside affects both arterial and venous dilation.
What condition may be linked to prolonged use of hydralazine?
What condition may be linked to prolonged use of hydralazine?
What role do beta-blockers play when combined with vasodilators?
What role do beta-blockers play when combined with vasodilators?
Why is sodium nitroprusside considered a mixed vasodilator?
Why is sodium nitroprusside considered a mixed vasodilator?
What physiological response can result from the use of vasodilators concerning fluid retention?
What physiological response can result from the use of vasodilators concerning fluid retention?
How does the action of nitrates differ from arterial vasodilators?
How does the action of nitrates differ from arterial vasodilators?
What is a significant concern when administering sodium nitroprusside?
What is a significant concern when administering sodium nitroprusside?
In which scenarios are mixed vasodilators most beneficial?
In which scenarios are mixed vasodilators most beneficial?
What is the mechanism by which minoxidil induces vasodilation?
What is the mechanism by which minoxidil induces vasodilation?
How is reflex sympathetic stimulation related to the use of vasodilators?
How is reflex sympathetic stimulation related to the use of vasodilators?
Arterial vasodilators like Nifedipine and Hydralazine are used to treat severe systemic ______.
Arterial vasodilators like Nifedipine and Hydralazine are used to treat severe systemic ______.
Venous vasodilators mainly reduce ______ by decreasing venous return.
Venous vasodilators mainly reduce ______ by decreasing venous return.
Mixed vasodilators such as Sodium nitroprusside and Prazosin decrease both preload and ______.
Mixed vasodilators such as Sodium nitroprusside and Prazosin decrease both preload and ______.
Vasodilators generally relax vascular smooth muscle and decrease peripheral ______.
Vasodilators generally relax vascular smooth muscle and decrease peripheral ______.
The use of vasodilators can lead to reflex sympathetic ______, such as tachycardia.
The use of vasodilators can lead to reflex sympathetic ______, such as tachycardia.
Due to their effects on aldosterone release, vasodilators often require combination with ______.
Due to their effects on aldosterone release, vasodilators often require combination with ______.
Nitrates are classified as ______ vasodilators.
Nitrates are classified as ______ vasodilators.
Hydralazine may cause a condition similar to systemic lupus erythematosus in fast ______.
Hydralazine may cause a condition similar to systemic lupus erythematosus in fast ______.
The use of vasodilators is declining as a result of newer modalities, such as ______ and CCBs.
The use of vasodilators is declining as a result of newer modalities, such as ______ and CCBs.
Hydralazine is used in severe hypertension and hypertension in ______.
Hydralazine is used in severe hypertension and hypertension in ______.
Hydralazine may cause systemic lupus erythematosus-like syndrome, especially in ______ acetylators.
Hydralazine may cause systemic lupus erythematosus-like syndrome, especially in ______ acetylators.
Minoxidil acts as a vasodilator by opening K+ channels, leading to ______ of vascular smooth muscle.
Minoxidil acts as a vasodilator by opening K+ channels, leading to ______ of vascular smooth muscle.
It is usually combined with diuretics to counteract salt and water ______.
It is usually combined with diuretics to counteract salt and water ______.
The patient develops a mild form of ______, renal impairment, and a skin rash that usually disappears upon stopping the drug.
The patient develops a mild form of ______, renal impairment, and a skin rash that usually disappears upon stopping the drug.
Hydralazine is a direct ______ by unclear mechanism.
Hydralazine is a direct ______ by unclear mechanism.
It is the third choice after ______ and nifedipine in treating hypertension in pregnancy.
It is the third choice after ______ and nifedipine in treating hypertension in pregnancy.
Sodium nitroprusside liberates ______ → ↑ cGMP → dilatation of both arteries and veins.
Sodium nitroprusside liberates ______ → ↑ cGMP → dilatation of both arteries and veins.
Diazoxide is ______ related to thiazides but it is not diuretic.
Diazoxide is ______ related to thiazides but it is not diuretic.
Fenoldopam stimulates peripheral ______ receptors in renal and mesenteric arteries.
Fenoldopam stimulates peripheral ______ receptors in renal and mesenteric arteries.
Endothelin-1 acts on two types of receptors, ______ and ETB.
Endothelin-1 acts on two types of receptors, ______ and ETB.
Sodium nitroprusside can be converted to ______ and thiocyanate.
Sodium nitroprusside can be converted to ______ and thiocyanate.
The accumulation of cyanide with sodium nitroprusside is minimized by concomitant administration of sodium ______.
The accumulation of cyanide with sodium nitroprusside is minimized by concomitant administration of sodium ______.
Diazoxide is given orally for ______ hypertension.
Diazoxide is given orally for ______ hypertension.
Sodium nitroprusside must be made up fresh before each administration and covered with ______ foil.
Sodium nitroprusside must be made up fresh before each administration and covered with ______ foil.
Bosentan is an orally active nonselective blocker of ETA and ETB ______.
Bosentan is an orally active nonselective blocker of ETA and ETB ______.
Sildenafil and tadalafil are drugs used for ______ dysfunction.
Sildenafil and tadalafil are drugs used for ______ dysfunction.
The effect of Sildenafil can be observed after ______ minutes of oral administration.
The effect of Sildenafil can be observed after ______ minutes of oral administration.
ACE inhibitors are the best choice for hypertension in a diabetic patient with ______.
ACE inhibitors are the best choice for hypertension in a diabetic patient with ______.
α-methyldopa is commonly prescribed for ______ during pregnancy.
α-methyldopa is commonly prescribed for ______ during pregnancy.
Sildenafil is also approved for treatment of ______ hypertension.
Sildenafil is also approved for treatment of ______ hypertension.
The contraindication for PDE type 5 inhibitors includes patients taking ______ for angina.
The contraindication for PDE type 5 inhibitors includes patients taking ______ for angina.
Patients taking ambrisentan are treated for primary pulmonary ______.
Patients taking ambrisentan are treated for primary pulmonary ______.
Match the following vasodilators with their primary mechanisms of action:
Match the following vasodilators with their primary mechanisms of action:
Match the following indications with the appropriate vasodilator:
Match the following indications with the appropriate vasodilator:
Match the following side effects with the associated vasodilator:
Match the following side effects with the associated vasodilator:
Match the combinations of medications with their purpose:
Match the combinations of medications with their purpose:
Match the vasodilators with their adverse effects:
Match the vasodilators with their adverse effects:
Match the following classes of vasodilators with their general effectiveness:
Match the following classes of vasodilators with their general effectiveness:
Match the following pharmacological effects with the correct drug:
Match the following pharmacological effects with the correct drug:
Match the drug to the condition where it is considered a choice:
Match the drug to the condition where it is considered a choice:
Match the following drugs to their primary action or usage:
Match the following drugs to their primary action or usage:
Match the following clinical conditions with their recommended antihypertensive treatment:
Match the following clinical conditions with their recommended antihypertensive treatment:
Match the following side effects with the drug class they are associated with:
Match the following side effects with the drug class they are associated with:
Match the following drugs to their unique characteristics:
Match the following drugs to their unique characteristics:
Match the following drugs to their contraindications:
Match the following drugs to their contraindications:
Match the following medication effects with their respective drugs:
Match the following medication effects with their respective drugs:
Match the following key points about PDE type 5 inhibitors:
Match the following key points about PDE type 5 inhibitors:
Match the following complications with their correlation to the drug class:
Match the following complications with their correlation to the drug class:
Match the following drugs with their primary clinical uses:
Match the following drugs with their primary clinical uses:
Match each vasodilator with its specific mechanism of action:
Match each vasodilator with its specific mechanism of action:
Match the following drugs with their associated risks or side effects:
Match the following drugs with their associated risks or side effects:
Match each drug with its method of administration:
Match each drug with its method of administration:
Match the following clinical effects to the appropriate vasodilators:
Match the following clinical effects to the appropriate vasodilators:
Match these vasodilators with their specific use in emergencies:
Match these vasodilators with their specific use in emergencies:
Match the following vasodilators with their impact on vascular smooth muscle:
Match the following vasodilators with their impact on vascular smooth muscle:
Match each vasodilator with a key characteristic:
Match each vasodilator with a key characteristic:
Match the following vasodilator categories with their primary actions:
Match the following vasodilator categories with their primary actions:
Match the following drugs to their classification as vasodilators:
Match the following drugs to their classification as vasodilators:
Match the following side effects with the appropriate vasodilator:
Match the following side effects with the appropriate vasodilator:
Match each vasodilator with its recommended combination partner:
Match each vasodilator with its recommended combination partner:
Match the following drug actions with their respective effects:
Match the following drug actions with their respective effects:
Match the following indications with the corresponding vasodilator classes:
Match the following indications with the corresponding vasodilator classes:
Match these drug effects to the mechanism of action:
Match these drug effects to the mechanism of action:
Match each vasodilator with the physiological effect it primarily targets:
Match each vasodilator with the physiological effect it primarily targets:
Study Notes
Vasoactive Agents Classification
- Arteriolators: Nifedipine, Hydralazine, Minoxidil, Diazoxide. They primarily dilate arteries, reducing both blood pressure (BP) and afterload, useful in severe systemic hypertension.
- Venodilators: Nitrates that mainly dilate veins, leading to decreased venous return and preload; used in acute pulmonary edema.
- Mixed Dilators: Sodium nitroprusside, Prazosin, ACE inhibitors, Trimethaphan. They reduce both preload and afterload, making them effective in congestive heart failure (CHF).
General Considerations
- Vasodilators relax vascular smooth muscle, decreasing peripheral resistance.
- Often induce reflex sympathetic stimulation, such as reflex tachycardia; commonly paired with beta-blockers to mitigate this effect.
- May cause salt and water retention due to aldosterone release; co-administration with diuretics is recommended.
- Their use is declining due to newer treatments like ACE inhibitors and calcium channel blockers (CCBs) which have better efficacy and fewer side effects.
Hydralazine
- Acts as a direct arteriolodilator through an unclear mechanism.
- Used for severe hypertension and hypertension during pregnancy (3rd choice).
- Generally combined with diuretics to reduce fluid retention and beta-blockers to prevent tachycardia.
- Can lead to a lupus-like syndrome, especially in slow acetylators, featuring arthritis, renal impairment, and skin rash.
Minoxidil
- Functions as a direct arteriolodilator by opening K+ channels, causing hyperpolarization and relaxation of vascular smooth muscle.
- Administered orally for chronic hypertension but its popularity is decreasing; often paired with diuretics and beta-blockers.
- Known to stimulate hair growth (hypertrichosis); is utilized topically to prevent hair loss.
Diazoxide
- Related to thiazides but lacks diuretic properties.
- Direct arteriolodilator by opening K+ channels; used parenterally in hypertensive emergencies but usage is declining.
Sodium Nitroprusside
- Releases nitric oxide (NO), increasing cGMP which leads to dilation of both arteries and veins, effectively reducing both preload and afterload.
- Administered via intravenous infusion for hypertensive emergencies and acute heart failure due to rapid action.
- Can convert to cyanide and thiocyanate; risk of toxicity mitigated by sodium thiosulfate or hydroxocobalamin.
- Sensitive to light; needs to be prepared fresh and covered in opaque foil.
Fenoldopam
- Stimulates peripheral dopamine (D1) receptors, causing vasodilation and decreased peripheral resistance.
- Administered parenterally as a rapid-acting vasodilator for emergency hypertension management.
Endothelin-1 Receptor Antagonists
- Endothelin-1 is a peptide released by the vascular endothelium, elevated in pulmonary hypertension and coronary artery disease.
- Acts on ETA (mediates vasoconstriction and hypertrophy) and ETB receptors.
- Bosentan is a nonselective blocker of both receptors; Ambrisentan selectively blocks ETA.
- Both are used to treat primary pulmonary hypertension.
Specialized Vasodilators for Erectile Dysfunction
- Sildenafil, Tadalafil: Inhibit phosphodiesterase type 5 (PDE5), leading to increased cGMP and vasodilation in the corpus cavernosum.
- Effective for erectile dysfunction; onset is 30 minutes with effects lasting 4-5 hours.
- Sildenafil is also used for pulmonary hypertension treatment.
- Side effects: blue vision, headache, optic neuropathy; contraindicated with nitrates/nicorandil due to severe vasodilation and hypotension risk.
Antihypertensive Drug Choices
- Non-complicated Hypertension: For a 55-year-old patient, best initial choice is CCBs, with thiazides or beta-blockers as add-ons if needed.
- Hypertension in Pregnancy: Preferred medications include α-methyldopa, Labetalol, Nifedipine, Hydralazine.
- Diabetic Nephropathy: ACE inhibitors are the best choice.
- Chronic Kidney Disease: S will be considered in treatment choices.
Vasoactive Agents Classification
- Arteriolators: Nifedipine, Hydralazine, Minoxidil, Diazoxide. They primarily dilate arteries, reducing both blood pressure (BP) and afterload, useful in severe systemic hypertension.
- Venodilators: Nitrates that mainly dilate veins, leading to decreased venous return and preload; used in acute pulmonary edema.
- Mixed Dilators: Sodium nitroprusside, Prazosin, ACE inhibitors, Trimethaphan. They reduce both preload and afterload, making them effective in congestive heart failure (CHF).
General Considerations
- Vasodilators relax vascular smooth muscle, decreasing peripheral resistance.
- Often induce reflex sympathetic stimulation, such as reflex tachycardia; commonly paired with beta-blockers to mitigate this effect.
- May cause salt and water retention due to aldosterone release; co-administration with diuretics is recommended.
- Their use is declining due to newer treatments like ACE inhibitors and calcium channel blockers (CCBs) which have better efficacy and fewer side effects.
Hydralazine
- Acts as a direct arteriolodilator through an unclear mechanism.
- Used for severe hypertension and hypertension during pregnancy (3rd choice).
- Generally combined with diuretics to reduce fluid retention and beta-blockers to prevent tachycardia.
- Can lead to a lupus-like syndrome, especially in slow acetylators, featuring arthritis, renal impairment, and skin rash.
Minoxidil
- Functions as a direct arteriolodilator by opening K+ channels, causing hyperpolarization and relaxation of vascular smooth muscle.
- Administered orally for chronic hypertension but its popularity is decreasing; often paired with diuretics and beta-blockers.
- Known to stimulate hair growth (hypertrichosis); is utilized topically to prevent hair loss.
Diazoxide
- Related to thiazides but lacks diuretic properties.
- Direct arteriolodilator by opening K+ channels; used parenterally in hypertensive emergencies but usage is declining.
Sodium Nitroprusside
- Releases nitric oxide (NO), increasing cGMP which leads to dilation of both arteries and veins, effectively reducing both preload and afterload.
- Administered via intravenous infusion for hypertensive emergencies and acute heart failure due to rapid action.
- Can convert to cyanide and thiocyanate; risk of toxicity mitigated by sodium thiosulfate or hydroxocobalamin.
- Sensitive to light; needs to be prepared fresh and covered in opaque foil.
Fenoldopam
- Stimulates peripheral dopamine (D1) receptors, causing vasodilation and decreased peripheral resistance.
- Administered parenterally as a rapid-acting vasodilator for emergency hypertension management.
Endothelin-1 Receptor Antagonists
- Endothelin-1 is a peptide released by the vascular endothelium, elevated in pulmonary hypertension and coronary artery disease.
- Acts on ETA (mediates vasoconstriction and hypertrophy) and ETB receptors.
- Bosentan is a nonselective blocker of both receptors; Ambrisentan selectively blocks ETA.
- Both are used to treat primary pulmonary hypertension.
Specialized Vasodilators for Erectile Dysfunction
- Sildenafil, Tadalafil: Inhibit phosphodiesterase type 5 (PDE5), leading to increased cGMP and vasodilation in the corpus cavernosum.
- Effective for erectile dysfunction; onset is 30 minutes with effects lasting 4-5 hours.
- Sildenafil is also used for pulmonary hypertension treatment.
- Side effects: blue vision, headache, optic neuropathy; contraindicated with nitrates/nicorandil due to severe vasodilation and hypotension risk.
Antihypertensive Drug Choices
- Non-complicated Hypertension: For a 55-year-old patient, best initial choice is CCBs, with thiazides or beta-blockers as add-ons if needed.
- Hypertension in Pregnancy: Preferred medications include α-methyldopa, Labetalol, Nifedipine, Hydralazine.
- Diabetic Nephropathy: ACE inhibitors are the best choice.
- Chronic Kidney Disease: S will be considered in treatment choices.
Vasoactive Agents Classification
- Arteriolators: Nifedipine, Hydralazine, Minoxidil, Diazoxide. They primarily dilate arteries, reducing both blood pressure (BP) and afterload, useful in severe systemic hypertension.
- Venodilators: Nitrates that mainly dilate veins, leading to decreased venous return and preload; used in acute pulmonary edema.
- Mixed Dilators: Sodium nitroprusside, Prazosin, ACE inhibitors, Trimethaphan. They reduce both preload and afterload, making them effective in congestive heart failure (CHF).
General Considerations
- Vasodilators relax vascular smooth muscle, decreasing peripheral resistance.
- Often induce reflex sympathetic stimulation, such as reflex tachycardia; commonly paired with beta-blockers to mitigate this effect.
- May cause salt and water retention due to aldosterone release; co-administration with diuretics is recommended.
- Their use is declining due to newer treatments like ACE inhibitors and calcium channel blockers (CCBs) which have better efficacy and fewer side effects.
Hydralazine
- Acts as a direct arteriolodilator through an unclear mechanism.
- Used for severe hypertension and hypertension during pregnancy (3rd choice).
- Generally combined with diuretics to reduce fluid retention and beta-blockers to prevent tachycardia.
- Can lead to a lupus-like syndrome, especially in slow acetylators, featuring arthritis, renal impairment, and skin rash.
Minoxidil
- Functions as a direct arteriolodilator by opening K+ channels, causing hyperpolarization and relaxation of vascular smooth muscle.
- Administered orally for chronic hypertension but its popularity is decreasing; often paired with diuretics and beta-blockers.
- Known to stimulate hair growth (hypertrichosis); is utilized topically to prevent hair loss.
Diazoxide
- Related to thiazides but lacks diuretic properties.
- Direct arteriolodilator by opening K+ channels; used parenterally in hypertensive emergencies but usage is declining.
Sodium Nitroprusside
- Releases nitric oxide (NO), increasing cGMP which leads to dilation of both arteries and veins, effectively reducing both preload and afterload.
- Administered via intravenous infusion for hypertensive emergencies and acute heart failure due to rapid action.
- Can convert to cyanide and thiocyanate; risk of toxicity mitigated by sodium thiosulfate or hydroxocobalamin.
- Sensitive to light; needs to be prepared fresh and covered in opaque foil.
Fenoldopam
- Stimulates peripheral dopamine (D1) receptors, causing vasodilation and decreased peripheral resistance.
- Administered parenterally as a rapid-acting vasodilator for emergency hypertension management.
Endothelin-1 Receptor Antagonists
- Endothelin-1 is a peptide released by the vascular endothelium, elevated in pulmonary hypertension and coronary artery disease.
- Acts on ETA (mediates vasoconstriction and hypertrophy) and ETB receptors.
- Bosentan is a nonselective blocker of both receptors; Ambrisentan selectively blocks ETA.
- Both are used to treat primary pulmonary hypertension.
Specialized Vasodilators for Erectile Dysfunction
- Sildenafil, Tadalafil: Inhibit phosphodiesterase type 5 (PDE5), leading to increased cGMP and vasodilation in the corpus cavernosum.
- Effective for erectile dysfunction; onset is 30 minutes with effects lasting 4-5 hours.
- Sildenafil is also used for pulmonary hypertension treatment.
- Side effects: blue vision, headache, optic neuropathy; contraindicated with nitrates/nicorandil due to severe vasodilation and hypotension risk.
Antihypertensive Drug Choices
- Non-complicated Hypertension: For a 55-year-old patient, best initial choice is CCBs, with thiazides or beta-blockers as add-ons if needed.
- Hypertension in Pregnancy: Preferred medications include α-methyldopa, Labetalol, Nifedipine, Hydralazine.
- Diabetic Nephropathy: ACE inhibitors are the best choice.
- Chronic Kidney Disease: S will be considered in treatment choices.
Vasoactive Agents Classification
- Arteriolators: Nifedipine, Hydralazine, Minoxidil, Diazoxide. They primarily dilate arteries, reducing both blood pressure (BP) and afterload, useful in severe systemic hypertension.
- Venodilators: Nitrates that mainly dilate veins, leading to decreased venous return and preload; used in acute pulmonary edema.
- Mixed Dilators: Sodium nitroprusside, Prazosin, ACE inhibitors, Trimethaphan. They reduce both preload and afterload, making them effective in congestive heart failure (CHF).
General Considerations
- Vasodilators relax vascular smooth muscle, decreasing peripheral resistance.
- Often induce reflex sympathetic stimulation, such as reflex tachycardia; commonly paired with beta-blockers to mitigate this effect.
- May cause salt and water retention due to aldosterone release; co-administration with diuretics is recommended.
- Their use is declining due to newer treatments like ACE inhibitors and calcium channel blockers (CCBs) which have better efficacy and fewer side effects.
Hydralazine
- Acts as a direct arteriolodilator through an unclear mechanism.
- Used for severe hypertension and hypertension during pregnancy (3rd choice).
- Generally combined with diuretics to reduce fluid retention and beta-blockers to prevent tachycardia.
- Can lead to a lupus-like syndrome, especially in slow acetylators, featuring arthritis, renal impairment, and skin rash.
Minoxidil
- Functions as a direct arteriolodilator by opening K+ channels, causing hyperpolarization and relaxation of vascular smooth muscle.
- Administered orally for chronic hypertension but its popularity is decreasing; often paired with diuretics and beta-blockers.
- Known to stimulate hair growth (hypertrichosis); is utilized topically to prevent hair loss.
Diazoxide
- Related to thiazides but lacks diuretic properties.
- Direct arteriolodilator by opening K+ channels; used parenterally in hypertensive emergencies but usage is declining.
Sodium Nitroprusside
- Releases nitric oxide (NO), increasing cGMP which leads to dilation of both arteries and veins, effectively reducing both preload and afterload.
- Administered via intravenous infusion for hypertensive emergencies and acute heart failure due to rapid action.
- Can convert to cyanide and thiocyanate; risk of toxicity mitigated by sodium thiosulfate or hydroxocobalamin.
- Sensitive to light; needs to be prepared fresh and covered in opaque foil.
Fenoldopam
- Stimulates peripheral dopamine (D1) receptors, causing vasodilation and decreased peripheral resistance.
- Administered parenterally as a rapid-acting vasodilator for emergency hypertension management.
Endothelin-1 Receptor Antagonists
- Endothelin-1 is a peptide released by the vascular endothelium, elevated in pulmonary hypertension and coronary artery disease.
- Acts on ETA (mediates vasoconstriction and hypertrophy) and ETB receptors.
- Bosentan is a nonselective blocker of both receptors; Ambrisentan selectively blocks ETA.
- Both are used to treat primary pulmonary hypertension.
Specialized Vasodilators for Erectile Dysfunction
- Sildenafil, Tadalafil: Inhibit phosphodiesterase type 5 (PDE5), leading to increased cGMP and vasodilation in the corpus cavernosum.
- Effective for erectile dysfunction; onset is 30 minutes with effects lasting 4-5 hours.
- Sildenafil is also used for pulmonary hypertension treatment.
- Side effects: blue vision, headache, optic neuropathy; contraindicated with nitrates/nicorandil due to severe vasodilation and hypotension risk.
Antihypertensive Drug Choices
- Non-complicated Hypertension: For a 55-year-old patient, best initial choice is CCBs, with thiazides or beta-blockers as add-ons if needed.
- Hypertension in Pregnancy: Preferred medications include α-methyldopa, Labetalol, Nifedipine, Hydralazine.
- Diabetic Nephropathy: ACE inhibitors are the best choice.
- Chronic Kidney Disease: S will be considered in treatment choices.
Vasoactive Agents Classification
- Arteriolators: Nifedipine, Hydralazine, Minoxidil, Diazoxide. They primarily dilate arteries, reducing both blood pressure (BP) and afterload, useful in severe systemic hypertension.
- Venodilators: Nitrates that mainly dilate veins, leading to decreased venous return and preload; used in acute pulmonary edema.
- Mixed Dilators: Sodium nitroprusside, Prazosin, ACE inhibitors, Trimethaphan. They reduce both preload and afterload, making them effective in congestive heart failure (CHF).
General Considerations
- Vasodilators relax vascular smooth muscle, decreasing peripheral resistance.
- Often induce reflex sympathetic stimulation, such as reflex tachycardia; commonly paired with beta-blockers to mitigate this effect.
- May cause salt and water retention due to aldosterone release; co-administration with diuretics is recommended.
- Their use is declining due to newer treatments like ACE inhibitors and calcium channel blockers (CCBs) which have better efficacy and fewer side effects.
Hydralazine
- Acts as a direct arteriolodilator through an unclear mechanism.
- Used for severe hypertension and hypertension during pregnancy (3rd choice).
- Generally combined with diuretics to reduce fluid retention and beta-blockers to prevent tachycardia.
- Can lead to a lupus-like syndrome, especially in slow acetylators, featuring arthritis, renal impairment, and skin rash.
Minoxidil
- Functions as a direct arteriolodilator by opening K+ channels, causing hyperpolarization and relaxation of vascular smooth muscle.
- Administered orally for chronic hypertension but its popularity is decreasing; often paired with diuretics and beta-blockers.
- Known to stimulate hair growth (hypertrichosis); is utilized topically to prevent hair loss.
Diazoxide
- Related to thiazides but lacks diuretic properties.
- Direct arteriolodilator by opening K+ channels; used parenterally in hypertensive emergencies but usage is declining.
Sodium Nitroprusside
- Releases nitric oxide (NO), increasing cGMP which leads to dilation of both arteries and veins, effectively reducing both preload and afterload.
- Administered via intravenous infusion for hypertensive emergencies and acute heart failure due to rapid action.
- Can convert to cyanide and thiocyanate; risk of toxicity mitigated by sodium thiosulfate or hydroxocobalamin.
- Sensitive to light; needs to be prepared fresh and covered in opaque foil.
Fenoldopam
- Stimulates peripheral dopamine (D1) receptors, causing vasodilation and decreased peripheral resistance.
- Administered parenterally as a rapid-acting vasodilator for emergency hypertension management.
Endothelin-1 Receptor Antagonists
- Endothelin-1 is a peptide released by the vascular endothelium, elevated in pulmonary hypertension and coronary artery disease.
- Acts on ETA (mediates vasoconstriction and hypertrophy) and ETB receptors.
- Bosentan is a nonselective blocker of both receptors; Ambrisentan selectively blocks ETA.
- Both are used to treat primary pulmonary hypertension.
Specialized Vasodilators for Erectile Dysfunction
- Sildenafil, Tadalafil: Inhibit phosphodiesterase type 5 (PDE5), leading to increased cGMP and vasodilation in the corpus cavernosum.
- Effective for erectile dysfunction; onset is 30 minutes with effects lasting 4-5 hours.
- Sildenafil is also used for pulmonary hypertension treatment.
- Side effects: blue vision, headache, optic neuropathy; contraindicated with nitrates/nicorandil due to severe vasodilation and hypotension risk.
Antihypertensive Drug Choices
- Non-complicated Hypertension: For a 55-year-old patient, best initial choice is CCBs, with thiazides or beta-blockers as add-ons if needed.
- Hypertension in Pregnancy: Preferred medications include α-methyldopa, Labetalol, Nifedipine, Hydralazine.
- Diabetic Nephropathy: ACE inhibitors are the best choice.
- Chronic Kidney Disease: S will be considered in treatment choices.
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Description
This quiz covers the classification and effects of vasodilators, including both arterial and venous types. It specifically discusses drugs such as Nifedipine, Hydralazine, and Minoxidil, focusing on their use in treating severe systemic hypertension. Test your knowledge on the mechanisms and applications of these important medications.