Vasodilators Classification
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Questions and Answers

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?

  • Arterial dilators
  • Non-selective vasodilators
  • Venodilators (correct)
  • Mixed dilators

    • 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?

    <p>They decrease both preload and afterload</p> Signup and view all the answers

    Which adverse effect often necessitates the combination of vasodilators with diuretics?

    <p>Salt and water retention</p> Signup and view all the answers

    What mechanism do vasodilators primarily use to relax vascular smooth muscle?

    <p>Decreased calcium influx</p> Signup and view all the answers

    What is a common characteristic of both arterial and venous vasodilators?

    <p>Both affect peripheral resistance</p> Signup and view all the answers

    Which of the following vasodilators primarily acts by decreasing peripheral resistance?

    <p>Sodium nitroprusside</p> Signup and view all the answers

    What role do vasodilators play in the management of hypertension?

    <p>Their use is declining due to newer alternatives that are more effective.</p> Signup and view all the answers

    Which drug is considered a third choice for treating hypertension in pregnancy?

    <p>Hydralazine</p> Signup and view all the answers

    What is a common side effect associated with hydralazine use?

    <p>Systemic lupus erythematosus-like syndrome</p> Signup and view all the answers

    Which mechanism describes the action of minoxidil in treating hypertension?

    <p>Opening of K+ channels resulting in hyperpolarization.</p> Signup and view all the answers

    Which of the following is a common practice when prescribing hydralazine?

    <p>Prescribing it with diuretics and beta-blockers.</p> Signup and view all the answers

    Why is hydralazine often paired with beta-blockers?

    <p>To counteract reflex tachycardia.</p> Signup and view all the answers

    What condition can develop as a side effect of long-term use of hydralazine?

    <p>Systemic lupus erythematosus-like syndrome</p> Signup and view all the answers

    How does vasodilation from minoxidil affect vascular smooth muscle?

    <p>It induces relaxation through hyperpolarization.</p> Signup and view all the answers

    What is the primary mechanism by which sodium nitroprusside exerts its action?

    <p>Liberation of nitric oxide</p> Signup and view all the answers

    Which of the following correctly describes the use of fenoldopam in clinical practice?

    <p>Administered as a rapid-acting vasodilator for emergency hypertension</p> Signup and view all the answers

    What is a major concern associated with sodium nitroprusside administration?

    <p>Conversion to toxic metabolites like cyanide</p> Signup and view all the answers

    Which receptors do endothelin-1 primarily act upon in vascular smooth muscle?

    <p>ETA and ETB receptors</p> Signup and view all the answers

    Which drug is known to combine well with diuretics and β-blockers for the treatment of chronic hypertension?

    <p>Diazoxide</p> Signup and view all the answers

    How should sodium nitroprusside be stored prior to administration?

    <p>In a dark container</p> Signup and view all the answers

    What effect does diazoxide have on the vascular smooth muscle?

    <p>Hyperpolarization and relaxation</p> Signup and view all the answers

    What is the primary indication for using arterial vasodilators like sodium nitroprusside?

    <p>Treatment of hypertensive emergencies</p> Signup and view all the answers

    What is the primary action of Bosentan in treating pulmonary hypertension?

    <p>Nonselective blockade of ETA and ETB receptors</p> Signup and view all the answers

    Which drug is contraindicated in patients taking nitrates?

    <p>Sildenafil</p> Signup and view all the answers

    In patients with chronic kidney disease, which is generally the best choice for antihypertensive therapy?

    <p>ACE inhibitors</p> Signup and view all the answers

    What is the typical duration of effect for drugs like Sildenafil after oral administration?

    <p>4-5 hours</p> Signup and view all the answers

    Which vasodilator is primarily used for the treatment of erectile dysfunction?

    <p>Tadalafil</p> Signup and view all the answers

    For a 55-year-old patient with non-complicated hypertension, which class of antihypertensive drugs is considered the best initial choice?

    <p>Calcium channel blockers</p> Signup and view all the answers

    What is a common side effect associated with the use of PDE type 5 inhibitors?

    <p>Blue discoloration of vision</p> Signup and view all the answers

    In patients suffering from hypertension during pregnancy, which medication is typically recommended?

    <p>Labetalol</p> Signup and view all the answers

    Diazoxide is a potent diuretic used to treat chronic hypertension.

    <p>False</p> Signup and view all the answers

    Sodium nitroprusside, when administered, can produce cyanide and thiocyanate as metabolites.

    <p>True</p> Signup and view all the answers

    Fenoldopam is primarily indicated for oral administration in chronic hypertension management.

    <p>False</p> Signup and view all the answers

    Endothelin-1 primarily causes vasodilation when it acts on its receptors.

    <p>False</p> Signup and view all the answers

    The primary action of sodium nitroprusside is to increase cGMP levels, resulting in vasodilation.

    <p>True</p> Signup and view all the answers

    Diazoxide should be used only for acute emergencies due to its high diuretic effect.

    <p>False</p> Signup and view all the answers

    Sodium nitroprusside must be shielded from light to prevent degradation before administration.

    <p>True</p> Signup and view all the answers

    The use of fenoldopam can induce vasoconstriction by stimulating D1 receptors.

    <p>False</p> Signup and view all the answers

    The use of diuretics in combination with hydralazine is primarily to enhance its vasodilatory effect.

    <p>False</p> Signup and view all the answers

    Hydralazine may lead to systemic lupus erythematosus-like syndrome, particularly in fast acetylators.

    <p>False</p> Signup and view all the answers

    Minoxidil acts as a vasodilator by opening K+ channels, leading to hyperpolarization of vascular smooth muscle.

    <p>True</p> Signup and view all the answers

    ACEI and CCBs are considered less effective than vasodilators like hydralazine in treating hypertension.

    <p>False</p> Signup and view all the answers

    Hydralazine is often the first-choice medication for hypertension in pregnancy.

    <p>False</p> Signup and view all the answers

    The direct arteriodilator action of hydralazine is attributed to its effect on K+ channels.

    <p>False</p> Signup and view all the answers

    Chronic use of hydralazine can result in a condition similar to rheumatoid arthritis.

    <p>True</p> Signup and view all the answers

    CCBs are known for causing more adverse effects compared to newer vasodilators such as ACEIs.

    <p>False</p> Signup and view all the answers

    Arterial dilators are primarily used to increase blood pressure.

    <p>False</p> Signup and view all the answers

    Venous dilators primarily act by reducing preload.

    <p>True</p> Signup and view all the answers

    Mixed vasodilators have no effect on both preload and afterload.

    <p>False</p> Signup and view all the answers

    Vasodilators can cause reflex sympathetic stimulation, often leading to reflex tachycardia.

    <p>True</p> Signup and view all the answers

    Sodium nitroprusside should be combined with a diuretic to prevent sodium retention.

    <p>True</p> Signup and view all the answers

    Nifedipine is classified as a venodilator.

    <p>False</p> Signup and view all the answers

    Diuretics are typically not needed when prescribing vasodilators due to their mechanism of action.

    <p>False</p> Signup and view all the answers

    Vasodilators selectively target only the smooth muscle of the arteries.

    <p>False</p> Signup and view all the answers

    Bosentan is a selective ETA blocker.

    <p>False</p> Signup and view all the answers

    Sildenafil's effect lasts for approximately 4-5 hours after administration.

    <p>True</p> Signup and view all the answers

    Nitric oxide also increases cGMP leading to vasodilation.

    <p>True</p> Signup and view all the answers

    ACE inhibitors are preferred for treating hypertension in diabetic patients with proteinuria.

    <p>True</p> Signup and view all the answers

    Tadalafil is a phosphodiesterase (PDE) type 2 inhibitor.

    <p>False</p> Signup and view all the answers

    Alpha-methyldopa is contraindicated for managing hypertension during pregnancy.

    <p>False</p> Signup and view all the answers

    Headache and blue discoloration of vision are common side effects of phosphodiesterase inhibitors.

    <p>True</p> Signup and view all the answers

    Labetalol is used primarily for treating chronic kidney disease.

    <p>False</p> Signup and view all the answers

    What is the primary reason for the decline in the use of vasodilators like hydralazine?

    <p>The decline is due to the effectiveness and fewer adverse effects of newer modalities such as ACE inhibitors and calcium channel blockers.</p> Signup and view all the answers

    Describe how hydralazine works as a vasodilator.

    <p>Hydralazine is a direct arteriolar dilator that works through an unclear mechanism, likely affecting smooth muscle relaxation.</p> Signup and view all the answers

    What condition may develop as a side effect of hydralazine, particularly in slow acetylators?

    <p>Hydralazine may cause a systemic lupus erythematosus-like syndrome.</p> Signup and view all the answers

    Why is hydralazine typically combined with diuretics?

    <p>It is combined with diuretics to counteract salt and water retention that can occur with its use.</p> Signup and view all the answers

    What mechanism underlies the action of minoxidil in vascular smooth muscle relaxation?

    <p>Minoxidil opens K+ channels, leading to hyperpolarization and subsequent relaxation of vascular smooth muscle.</p> Signup and view all the answers

    What role do beta-blockers play when hydralazine is prescribed?

    <p>Beta-blockers are used to counteract reflex tachycardia that hydralazine may cause.</p> Signup and view all the answers

    What are the three choices of antihypertensive medications for pregnant patients?

    <p>The three choices are alpha-methyldopa, nifedipine, and hydralazine.</p> Signup and view all the answers

    What is a notable adverse effect of long-term hydralazine use?

    <p>Chronic use can lead to symptoms resembling rheumatoid arthritis.</p> Signup and view all the answers

    What distinguishes ambrisentan from bosentan in terms of receptor selectivity?

    <p>Ambrisentan is a selective blocker of ETA receptors, while bosentan is a nonselective blocker of both ETA and ETB receptors.</p> Signup and view all the answers

    Identify a significant contraindication for the use of PDE type 5 inhibitors.

    <p>PDE type 5 inhibitors are contraindicated in patients taking nitrates.</p> Signup and view all the answers

    For a patient with diabetic nephropathy, which class of antihypertensive medication is preferred?

    <p>ACE inhibitors are preferred for patients with diabetic nephropathy.</p> Signup and view all the answers

    What is the primary mechanism of action of sildenafil in treating erectile dysfunction?

    <p>Sildenafil inhibits phosphodiesterase type 5, leading to increased levels of cGMP and vasodilation in erectile tissue.</p> Signup and view all the answers

    Which drug class should be administered as the first-line treatment for uncomplicated hypertension in a 55-year-old patient?

    <p>Calcium channel blockers (CCBs) are considered the best initial choice.</p> Signup and view all the answers

    What are common side effects associated with PDE type 5 inhibitors?

    <p>Common side effects include blue discoloration of vision and headaches.</p> Signup and view all the answers

    What treatment is commonly recommended for hypertension during pregnancy?

    <p>α-methyldopa is commonly recommended for managing hypertension in pregnant patients.</p> Signup and view all the answers

    Describe the impact of sildenafil's onset time and duration of action upon administration.

    <p>Sildenafil typically takes about 30 minutes to take effect and lasts for 4-5 hours.</p> Signup and view all the answers

    What is the mechanism by which sodium nitroprusside achieves vasodilation?

    <p>It liberates nitric oxide (NO), increasing cGMP levels, which leads to vascular relaxation.</p> Signup and view all the answers

    Why should sodium nitroprusside be protected from light before administration?

    <p>Sodium nitroprusside is sensitive to light, which can degrade the drug and render it ineffective.</p> Signup and view all the answers

    How does fenoldopam specifically act on peripheral dopamine receptors and what is the result?

    <p>Fenoldopam stimulates peripheral dopamine (D1) receptors, leading to vasodilation and decreased peripheral resistance.</p> Signup and view all the answers

    What role do endothelin-1 receptor antagonists play in vascular function?

    <p>Endothelin-1 receptor antagonists block the vasoconstrictive effects of endothelin-1, promoting vascular relaxation.</p> Signup and view all the answers

    What is a significant risk associated with the administration of sodium nitroprusside?

    <p>A significant risk is the potential accumulation of cyanide and thiocyanate, which can lead to toxicity.</p> Signup and view all the answers

    What is the clinical application of diazoxide in the context of hypertension?

    <p>Diazoxide is used parenterally to manage hypertensive emergencies but is mostly declining in use for chronic hypertension.</p> Signup and view all the answers

    Explain how sodium nitroprusside affects both arterial and venous dilation.

    <p>Sodium nitroprusside causes relaxation of both arteries and veins due to elevated cGMP levels.</p> Signup and view all the answers

    What condition may be linked to prolonged use of hydralazine?

    <p>Prolonged use of hydralazine can be associated with systemic lupus erythematosus-like syndrome.</p> Signup and view all the answers

    What role do beta-blockers play when combined with vasodilators?

    <p>Beta-blockers are combined with vasodilators to mitigate reflex tachycardia caused by vasodilation.</p> Signup and view all the answers

    Why is sodium nitroprusside considered a mixed vasodilator?

    <p>Sodium nitroprusside is classified as a mixed vasodilator because it decreases both preload and afterload.</p> Signup and view all the answers

    What physiological response can result from the use of vasodilators concerning fluid retention?

    <p>Vasodilators can cause salt and water retention due to the reflex stimulation of aldosterone release.</p> Signup and view all the answers

    How does the action of nitrates differ from arterial vasodilators?

    <p>Nitrates primarily act as venodilators, reducing venous return, while arterial vasodilators lower afterload.</p> Signup and view all the answers

    What is a significant concern when administering sodium nitroprusside?

    <p>A major concern with sodium nitroprusside is the potential for cyanide toxicity with prolonged use.</p> Signup and view all the answers

    In which scenarios are mixed vasodilators most beneficial?

    <p>Mixed vasodilators are beneficial in managing conditions like congestive heart failure as they address both preload and afterload.</p> Signup and view all the answers

    What is the mechanism by which minoxidil induces vasodilation?

    <p>Minoxidil induces vasodilation by opening potassium channels in vascular smooth muscle cells.</p> Signup and view all the answers

    How is reflex sympathetic stimulation related to the use of vasodilators?

    <p>Vasodilators can trigger reflex sympathetic stimulation, resulting in increased heart rate and blood volume.</p> Signup and view all the answers

    Arterial vasodilators like Nifedipine and Hydralazine are used to treat severe systemic ______.

    <p>hypertension</p> Signup and view all the answers

    Venous vasodilators mainly reduce ______ by decreasing venous return.

    <p>preload</p> Signup and view all the answers

    Mixed vasodilators such as Sodium nitroprusside and Prazosin decrease both preload and ______.

    <p>afterload</p> Signup and view all the answers

    Vasodilators generally relax vascular smooth muscle and decrease peripheral ______.

    <p>resistance</p> Signup and view all the answers

    The use of vasodilators can lead to reflex sympathetic ______, such as tachycardia.

    <p>stimulation</p> Signup and view all the answers

    Due to their effects on aldosterone release, vasodilators often require combination with ______.

    <p>diuretics</p> Signup and view all the answers

    Nitrates are classified as ______ vasodilators.

    <p>venous</p> Signup and view all the answers

    Hydralazine may cause a condition similar to systemic lupus erythematosus in fast ______.

    <p>acetylators</p> Signup and view all the answers

    The use of vasodilators is declining as a result of newer modalities, such as ______ and CCBs.

    <p>ACEIs</p> Signup and view all the answers

    Hydralazine is used in severe hypertension and hypertension in ______.

    <p>pregnancy</p> Signup and view all the answers

    Hydralazine may cause systemic lupus erythematosus-like syndrome, especially in ______ acetylators.

    <p>slow</p> Signup and view all the answers

    Minoxidil acts as a vasodilator by opening K+ channels, leading to ______ of vascular smooth muscle.

    <p>hyperpolarization</p> Signup and view all the answers

    It is usually combined with diuretics to counteract salt and water ______.

    <p>retention</p> Signup and view all the answers

    The patient develops a mild form of ______, renal impairment, and a skin rash that usually disappears upon stopping the drug.

    <p>arthritis</p> Signup and view all the answers

    Hydralazine is a direct ______ by unclear mechanism.

    <p>arteriolar dilator</p> Signup and view all the answers

    It is the third choice after ______ and nifedipine in treating hypertension in pregnancy.

    <p>alpha-methyldopa</p> Signup and view all the answers

    Sodium nitroprusside liberates ______ → ↑ cGMP → dilatation of both arteries and veins.

    <p>nitric oxide</p> Signup and view all the answers

    Diazoxide is ______ related to thiazides but it is not diuretic.

    <p>structurally</p> Signup and view all the answers

    Fenoldopam stimulates peripheral ______ receptors in renal and mesenteric arteries.

    <p>dopamine</p> Signup and view all the answers

    Endothelin-1 acts on two types of receptors, ______ and ETB.

    <p>ETA</p> Signup and view all the answers

    Sodium nitroprusside can be converted to ______ and thiocyanate.

    <p>cyanide</p> Signup and view all the answers

    The accumulation of cyanide with sodium nitroprusside is minimized by concomitant administration of sodium ______.

    <p>thiosulfate</p> Signup and view all the answers

    Diazoxide is given orally for ______ hypertension.

    <p>chronic</p> Signup and view all the answers

    Sodium nitroprusside must be made up fresh before each administration and covered with ______ foil.

    <p>opaque</p> Signup and view all the answers

    Bosentan is an orally active nonselective blocker of ETA and ETB ______.

    <p>receptors</p> Signup and view all the answers

    Sildenafil and tadalafil are drugs used for ______ dysfunction.

    <p>erectile</p> Signup and view all the answers

    The effect of Sildenafil can be observed after ______ minutes of oral administration.

    <p>30</p> Signup and view all the answers

    ACE inhibitors are the best choice for hypertension in a diabetic patient with ______.

    <p>diabetic nephropathy</p> Signup and view all the answers

    α-methyldopa is commonly prescribed for ______ during pregnancy.

    <p>hypertension</p> Signup and view all the answers

    Sildenafil is also approved for treatment of ______ hypertension.

    <p>pulmonary</p> Signup and view all the answers

    The contraindication for PDE type 5 inhibitors includes patients taking ______ for angina.

    <p>nitrates</p> Signup and view all the answers

    Patients taking ambrisentan are treated for primary pulmonary ______.

    <p>hypertension</p> Signup and view all the answers

    Match the following vasodilators with their primary mechanisms of action:

    <p>Hydralazine = Direct arteriolar dilator Minoxidil = Opens K+ channels Nifedipine = Calcium channel blocker ACEIs = Inhibits angiotensin-converting enzyme</p> Signup and view all the answers

    Match the following indications with the appropriate vasodilator:

    <p>Hydralazine = Severe hypertension in pregnancy Minoxidil = Chronic hypertension Nitroglycerin = Acute chest pain Fenoldopam = Acute hypertension management</p> Signup and view all the answers

    Match the following side effects with the associated vasodilator:

    <p>Hydralazine = Systemic lupus erythematosus-like syndrome Minoxidil = Hypertrichosis Nitroprusside = Cyanide toxicity Nifedipine = Peripheral edema</p> Signup and view all the answers

    Match the combinations of medications with their purpose:

    <p>Hydralazine + Diuretics = Counteract salt and water retention Hydralazine + β-blockers = Counteract reflex tachycardia Minoxidil + Diuretics = Prevent fluid retention ACEIs + CCBs = Enhanced antihypertensive effect</p> Signup and view all the answers

    Match the vasodilators with their adverse effects:

    <p>Hydralazine = Mild arthritis Minoxidil = Excessive hair growth ACEIs = Cough CCBs = Dynamic heart rate changes</p> Signup and view all the answers

    Match the following classes of vasodilators with their general effectiveness:

    <p>Hydralazine = Older generation ACEIs = More effective with fewer adverse effects Minoxidil = Direct effect on vascular smooth muscle CCBs = Associated with higher rates of side effects</p> Signup and view all the answers

    Match the following pharmacological effects with the correct drug:

    <p>Hydralazine = Reduces systemic vascular resistance Minoxidil = Induces smooth muscle relaxation Nifedipine = Inhibits calcium influx Nitroglycerin = Dilates venous capacitance vessels</p> Signup and view all the answers

    Match the drug to the condition where it is considered a choice:

    <p>Hydralazine = Third choice for hypertension in pregnancy Minoxidil = Refractory hypertension Nifedipine = Frequent use in acute angina ACEIs = First-line for chronic hypertension</p> Signup and view all the answers

    Match the following drugs to their primary action or usage:

    <p>Bosentan = Nonselective blocker of ETA and ETB receptors Ambrisentan = Selective ETA blocker Sildenafil = Inhibitor of PDE type 5 Tadalafil = Treatment for erectile dysfunction</p> Signup and view all the answers

    Match the following clinical conditions with their recommended antihypertensive treatment:

    <p>Non-complicated hypertension = Calcium channel blockers (CCBs) Hypertension during pregnancy = α-methyldopa Diabetic nephropathy = ACE inhibitors Chronic kidney disease = Sodium nitroprusside</p> Signup and view all the answers

    Match the following side effects with the drug class they are associated with:

    <p>Blue discoloration of vision = PDE type 5 inhibitors Headache = PDE type 5 inhibitors Optic neuropathy = PDE type 5 inhibitors Severe hypotension = Nitrates</p> Signup and view all the answers

    Match the following drugs to their unique characteristics:

    <p>Sildenafil = Approved for pulmonary hypertension Tadalafil = Longer duration of action compared to Sildenafil Ambrisentan = Used for primary pulmonary hypertension α-methyldopa = Recommended for hypertension in pregnancy</p> Signup and view all the answers

    Match the following drugs to their contraindications:

    <p>Sildenafil = Nitrates Tadalafil = Nitrates Bosentan = Pregnancy Ambrisentan = Adverse reactions in compromised liver function</p> Signup and view all the answers

    Match the following medication effects with their respective drugs:

    <p>Minoxidil = Opens K+ channels Hydralazine = Direct arteriodilator action Fenoldopam = Stimulates D1 receptors Sodium nitroprusside = Produces cyanide and thiocyanate as metabolites</p> Signup and view all the answers

    Match the following key points about PDE type 5 inhibitors:

    <p>Sildenafil = Used for erectile dysfunction Tadalafil = Effective for pulmonary hypertension</p> Signup and view all the answers

    Match the following complications with their correlation to the drug class:

    <p>Headache = PDE inhibitors Reflex tachycardia = Nitrates Systemic lupus erythematosus-like syndrome = Hydralazine Hypotension = α-methyldopa</p> Signup and view all the answers

    Match the following drugs with their primary clinical uses:

    <p>Diazoxide = Topical treatment for hair loss Sodium nitroprusside = Emergency hypertension management Fenoldopam = Treating renal artery vasodilation Endothelin-1 receptor antagonists = Management of pulmonary hypertension</p> Signup and view all the answers

    Match each vasodilator with its specific mechanism of action:

    <p>Diazoxide = Opens K+ channels leading to hyperpolarization Sodium nitroprusside = Liberates nitric oxide (NO) increasing cGMP Fenoldopam = Stimulates D1 receptors causing vasodilation Endothelin-1 receptor antagonists = Blocks ETA and ETB receptors in smooth muscle</p> Signup and view all the answers

    Match the following drugs with their associated risks or side effects:

    <p>Sodium nitroprusside = Risk of cyanide toxicity Diazoxide = Skin hypertrichosis Fenoldopam = Elevated heart rate due to vasodilation Endothelin-1 receptor antagonists = Potential for fluid retention</p> Signup and view all the answers

    Match each drug with its method of administration:

    <p>Diazoxide = Oral administration Sodium nitroprusside = Intravenous infusion Fenoldopam = Parenteral administration Endothelin-1 receptor antagonists = Oral administration</p> Signup and view all the answers

    Match the following clinical effects to the appropriate vasodilators:

    <p>Diazoxide = Releases potassium ions leading to smooth muscle relaxation Sodium nitroprusside = Decreases both preload and afterload Fenoldopam = Increases renal blood flow Endothelin-1 receptor antagonists = Reduces vascular resistance</p> Signup and view all the answers

    Match these vasodilators with their specific use in emergencies:

    <p>Diazoxide = Vasodilator for chronic hypertension Sodium nitroprusside = Vasodilator for hypertensive emergencies Fenoldopam = Emergency treatment of hypertension in hospitalized patients Endothelin-1 receptor antagonists = Chronic treatment of pulmonary hypertension</p> Signup and view all the answers

    Match the following vasodilators with their impact on vascular smooth muscle:

    <p>Diazoxide = Hyperpolarizes and relaxes smooth muscle Sodium nitroprusside = Induces vasodilation via NO pathway Fenoldopam = Activates D1 dopamine receptors causing vasodilation Endothelin-1 receptor antagonists = Inhibits vasoconstriction effect of endothelin-1</p> Signup and view all the answers

    Match each vasodilator with a key characteristic:

    <p>Diazoxide = Stimulates hair growth as a side effect Sodium nitroprusside = Sensitive to light and must be freshly prepared Fenoldopam = Acts on renal and mesenteric arteries Endothelin-1 receptor antagonists = Targets endothelin-1 peptide receptors</p> Signup and view all the answers

    Match the following vasodilator categories with their primary actions:

    <p>Arterial dilators = Decrease afterload Venous dilators = Decrease preload Mixed dilators = Decrease both preload and afterload Nitrates = Dilate veins</p> Signup and view all the answers

    Match the following drugs to their classification as vasodilators:

    <p>Nifedipine = Arterial dilator Nitroglycerin = Venous dilator Sodium nitroprusside = Mixed dilator Prazosin = Mixed dilator</p> Signup and view all the answers

    Match the following side effects with the appropriate vasodilator:

    <p>Hydralazine = Systemic lupus erythematosus-like syndrome Minoxidil = Fluid retention Sodium nitroprusside = Cyanide toxicity Diazoxide = Hypoglycemia</p> Signup and view all the answers

    Match each vasodilator with its recommended combination partner:

    <p>Arterial vasodilators = Beta-blockers Venous vasodilators = Diuretics Mixed vasodilators = Diuretics All vasodilators = ACE inhibitors</p> Signup and view all the answers

    Match the following drug actions with their respective effects:

    <p>Nitrates = Improved venous return Minoxidil = Increased K+ channel opening Benazepril = Reduced peripheral resistance Hydralazine = Increased vascular smooth muscle relaxation</p> Signup and view all the answers

    Match the following indications with the corresponding vasodilator classes:

    <p>Arterial dilators = Severe systemic hypertension Venous dilators = Acute pulmonary edema Mixed dilators = Congestive heart failure Nitrates = Angina relief</p> Signup and view all the answers

    Match these drug effects to the mechanism of action:

    <p>Arterial dilation = Increased cGMP levels Venous dilation = Increased nitric oxide release Decreased preload = Venous pooling of blood Decreased afterload = Reduced vascular resistance</p> Signup and view all the answers

    Match each vasodilator with the physiological effect it primarily targets:

    <p>Hydralazine = Decreases systemic vascular resistance Nifedipine = Specific vasodilation of coronary arteries Nitroglycerin = Primarily affects large veins Minoxidil = Relaxes vascular smooth muscle via potassium channels</p> Signup and view all the answers

    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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    Vasodilators in Cardiovascular Pharmacology PDF

    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.

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