1. Question
Raymund is reviewing cardiovascular drugs for his upcoming exam. For a well-
prepared student, he should know that vasodilators are agents that:
A. Relax smooth muscles.
Correct Answer
B. Are used to treat hypotension.
C. Stimulate the adrenergic receptors of peripheral sympathetic nerves.
Incorrect
D. Cause respiratory depression.
Incorrect
Correct Answer: A. Relax smooth muscles.
Vasodilators relax smooth muscle. Vasodilators dilate or prevent constriction of
the blood vessels, which allow greater blood flow to various organs in the body.
Many vasodilators bind to receptors on endothelial cells of the blood vessel,
which stimulate calcium release. Calcium activates the enzyme nitric oxide
,synthase (NO synthase) and converts L-arginine into NO. It leaves the endothelial
cell via diffusion and enters vascular smooth muscle cells. NO activates GTP and
converts it into cGMP. cGMP then stimulates myosin-light chain phosphatase,
which removes a single phosphate from myosin and actin filaments. The
dephosphorylation of myosin and actin filaments allows vascular smooth muscle
relaxation.
Option B: They are used to treat hypertension, not hypotension. Vasodilators are
useful in treating a variety of medical conditions, most commonly systemic
hypertension. Other diseases include myocardial infarction (both ST-segment
elevation and non-ST-segment elevation), angina, heart failure, stroke, chronic
kidney disease, preeclampsia, hypertensive emergency.
Option C: Stimulating the adrenergic receptors of peripheral sympathetic nerves
causes blood vessels to contract. Nitrates increase the amount of nitric oxide in
vascular smooth muscle cells, causing vasodilation. Nitrates dilate veins more
than arteries and decrease preload.
Option D: Respiratory depression is not an action of vasodilators. Respiratory
depression is among the more serious adverse reactions with opiate use that is
especially important to monitor in the postoperative patient population.
2. Question
As a competent nurse, you are aware that vasodilators are used mainly to treat:
A. Diabetes
,B. Hypertension
Correct
C. Atrial fibrillation
D. Hypotension
Correct
Correct Answer: B. Hypertension
Vasodilators are used to treat hypertension. Vasodilators are useful in treating a
variety of medical conditions, most commonly systemic hypertension. Other
diseases include myocardial infarction (both ST-segment elevation and non-ST-
segment elevation), angina, heart failure, stroke, chronic kidney disease,
preeclampsia, hypertensive emergency.
Option A: They are not used to treat diabetes. Since T1DM is a disease primarily
due to the absence of insulin, insulin administration through daily injections, or an
insulin pump, is the mainstay of treatment. In T2DM, diet and exercise may be
adequate treatments, especially initially. Other therapies may target insulin
sensitivity or increase insulin secretion by the pancreas. The specific subclasses
for drugs include biguanides (metformin), sulfonylureas, meglitinides, alpha-
glucosidase inhibitors, thiazolidinediones, glucagon like-peptide-1 agonist,
dipeptidyl peptidase IV inhibitors, selective, amylinomimetics, and sodium-
glucose transporter-2 inhibitors.
, Option C: Atrial fibrillation is not treated with vasodilators. If there is evidence of
rapid ventricular response, a beta-blocker or calcium-channel blocker should be
commenced for rate control. These options can be used in the intravenous (IV)
form for rapid response. Usually, a bolus is administered to the patient and then
started on a drip if symptoms do not resolve.
Option D: Vasodilators are not used to treat hypotension. Asymptomatic
hypotension should not receive drastic interventions. However, if symptoms are
present, the treatment of hypotension should focus on reversing the underlying
etiology.
3. Question
The drug/drugs used most commonly to treat peripheral or cerebral vascular
obstructive disease is/are:
A. pentoxifylline (Trental)
B. cyclandelate (Cyclan)
C. isoxsuprine (Vasodilan)
D. All of the above
Correct
Correct
Correct Answer: D. All of the above