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Direct-Acting Vasodilators

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Topic updated on 05/29/17 7:30pm

Hydralazine
  • Mechanism 
    • ↑ cGMP → smooth muscle relaxation
      • results in ↓ TPR
      • can stimulate reflex tachycardia
        • frequently coadministered with a β-blocker to inhibit compensatory action
    • vasodilates arterioles > veins
  • Clinical use
    • moderate/severe hypertension
      • ↓ BP
    • CHF
      • ↓ afterload
    • hypertension in pregnancy
      • with methyldopa
  • Toxicity
    • contraindicated in angina/CAD
      • can ↑ cardiac demand
    • fluid retention
    • headache
    • lupus-like syndrome (especially for slow acetylators)
      • hydrALAzine : ANA
Minoxidil
  • Mechanism
    • K+-channel opener
      • hyperpolarizes and relaxes vascular smooth muscle
  • Clinical use
    • severe hypertension
  • Toxicity
    • hypertrichosis
      • active ingredient in topical Rogaine
    • pericardial effusion
    • reflex tachycardia
    • angina
    • salt retention


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