[PCOL2-LEC-PRE-03-PT2] CARDIOVASCULAR DRUGS: ANTI-ANGINALS

THIS FLASH CARDS IS ABOUT [PCOL] CARDIOVASCULAR DRUGS: ANTI-ANGINALS

Nitrovasodilators

This classification of drug acts on the coronary arteries.

Info

Non-vasodilators: With Beta-blockers, it blocks the B₁-receptors causing relaxation (cardiac depressant effect).

Info

Effects of PK-A:

• Blood Vessel — high PKA for relaxation

• Heart — low PKA for no contraction

Sodium Nitroprusside

Nitrovasodilators:

This can readily release the Nitric Oxide (NO)

Nitric oxide synthase

• Co-factor: Sulfhydryl group-containing compounds

Due to this enzyme, the metabolism of organic nitrite and nitrates occurs.

Relaxation

CGMP promotes?

True

True or False:

The effects of nitrovasodilators is dose-dependent.

Peripheral Venodilation (increased stored blood in the veins)

↓ preload

↓ workload

↓ O₂ demand

Pharmacological Effects of Nitrates:

At regular/low doses (ISDN 5mg SL, NTG 0.6mg SL), what is the effect?

• Treatment for CSAP/Effort Angina.

Increased peripheral venous pooling of blood.

Decreases preload/venous return.

Decreased myocardial wall tension.

Decreased O₂ requirements and reduce tissue pressure.

Additional arteriolar and coronary artery vasodilation

Pharmacological Effects of Nitrates:

At high doses (High Dose IV infusion), what is the effect?

• Treatment for Prinzmetal Angina.

Reduced mean arterial pressure.

Reduced afterload.

Diminish O₂ requirements.

Increased O₂ supply.

Info

Other Effects of Nitrates:

• Relaxation (brief effect)

  • Bronchi

  • GIT

  • Biliary Tract

  • GUT

  • Corpus Cavernosum (penile tissue)

• Platelets - decreased aggregation (potential for bleeding)

• Other effect: Methemoglobinemia

Amyl nitrite

This drug is a well-documented cause of acquired methemoglobinemia.

Cyanide poisoning

Amyl nitrite is used as an antidote for ________ poisoning (one of the ingredients)

Viagra

Sildenafil is marketed under the brand name?

Erectogenic (causes erection)

Sildenafil, Tadalafil, and Vardenafil are what type of drugs?

Erectile dysfunction

Sildenafil, Tadalafil, and Vardenafil are used in the treatment of?

Nitrates

Sildenafil potentiates the action of?

Info

D/I with PDE₅ Inhibitors with Nitrates: Sildenafil, Tadalafil, Vardenafil

• Severe hypotension and a few myocardial infarctions have been reported in men taking both drugs.

6 hours

D/I with PDE₅ Inhibitors with Nitrates: Sildenafil, Tadalafil, Vardenafil

• It is recommended that at least ___ hours pass between use of a nitrate and the ingestion of sildenafil.

1. Color vision

2. Blue-green

Sildenafil also has effects on (1)_____, causing difficulty in (2)________ discrimination.

<5-10 minutes

Classes of Nitrovasodilators:

How long does very short-acting drugs lasts?

Amyl nitrite

This is an example of drug for very short-acting; the only nitrite (inhalation).

10-30 minutes

Classes of Nitrovasodilators:

How long does short-acting drugs lasts?

• Isosorbide dinitrate (ISDN) SL, Nitroglycerin (NTG) SL

Isordil

Isosorbide dinitrate (ISDN) is marketed under what brand name?

5-8 hours

Classes of Nitrovasodilators:

How long does intermediate-acting drugs lasts?

• Isosorbide dinitrate (ISDN) tab PO, Nitroglycerin (NTG-SR) tab PO

10-24 hours

Classes of Nitrovasodilators:

How long does long-acting drugs lasts?

• Isosorbide dinitrate (ISDN) tab PO, Isosorbide mononitrate (ISMN) tab PO, Nitroglycerin (NTG) Transdermal Patches

Indur

Isosorbide mononitrate (ISMN) is marketed under what brand name?

Tolerance

Adverse Effects of Nitrovasodilators:

Develops when nitrate serum levels are sustained over time.