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methemoglobinemia and cyanide poisoning are caused by what vasodilating drug?
SNP
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name 6 peripheral vasodilators:
Sat night high (@ the) PTA
- SNP
- NTG
- Hydralazine
- Papavarine
- Trimethaphan
- Adenosine
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When should vasodilators be used and why?
- HTN crisis tx, controlled HTN, improve LV SV for CHF or regurge.
- can be "finely controlled"
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what is mechanism of vasodilators and what does it do?
NO, decreases SVR and RA filling
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NO production is related to what second messenger?
cGmp
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NO is a chemical messenger that helps maintain __ tone, plt __________ and ___ ____________. Also aids in __ relaxation and immune function.
- CV
- aggregation
- CNS signaling
- GI
-
NO duration and inactivation:
-
What are phys fx of NO?
arteries dilate more than veins, basal PVr/SVR, cardiac output distribution management. (naturally)
-
name "other" FX of NO: PPNI
- pulmonary bronchodilation
- plt aggregation
- NT
- Immune fx
-
Essential HTN is thought to be cuase by a decrease in __ production.
NO
-
clinical uses of NO
- inhaled=
- pulmonary HTN (common with lung transplants),
- ARDS
-
when using what drug, increase FGF to greater than ______ ___________
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SNP is not what?
selective. dilates veins as much as arteries. causes decrease in preload and afterload
-
what is the dose, onset and duration of SNP?
- 0.3-20mcg/kg/min
- 30 sec
- 1 min
-
Cyanide tox can be seen at what dose of SNP?
>2mcg/kg/min
-
at low doses, SNP will cause a greater ________ than ________
- afterload
- preload (think alphabetical order)
-
What a few bad things about SNP?
- light sensitive
- reflex tachy
- vascular steal
- ischemia
- rebound HTN
- increased ICP risk
- inhibit plt fxn
- Thiocyanate, cyanide, mgbh
- N/V from drop in BP
-
what happens with cyanide tox?
how should is be treated?
- tissue anoxia, anaerobic metabolism, lactic acidosis
- stop SNP, hyperventilate, give bicarb, Na thiosulfate
-
what is the tx of thiocyanate tox? why does it occur and what are symptoms?
- dialysis
- impaired renal clearance
- fatigue, tinnitus, N/V
-
Tx for MHGBemia. Pulse ox reading?
-
Why is SNP used?
- controlled hypotension
- HTN emergencies
- cardiac dz
- aortic surgery
-
NTG mostly dilates ______. Decreases ________ ____ tension.
-
Why is NTG taken sublingual?
bypass 1st pass metabolism
-
What is the Mechanism of NTG?
pharmicokinetics?
organ fx?
- cGMP
- short 1/2 life
- uterine relaxation
-
Uses of NTG:
- angina pectoris
- cardiac failure
- acute HTN
- controlled hypotension
-
Hydralazine is mainly a ________ dilator. Onset?
Side fx?
Use?
- ARTERIAL
- 15-20 min
- reflex tachy, rash, headache, flushing, angina
- HTN
-
Hyrdalazine maintains blood flow to ______. what are 2 bad side fx?
- Uterus
- coronary steal, lupus like syndrome
-
Adenosine has a half life of ___ to ____ sec and is used to treat ____. it is an _________ nucleotide and potent _______ ___________.
- 0.6 to 1.5
- PSVT
- endogenous
- coronary vasodilator
-
What are side fx of trimethaphan?
midriasis, stomach cramping
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