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Vasodilation - The goal of vasodilator therapy are To bring...

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The goal of vasodilator therapy are: - To bring myocardial oxygen demand and myocardial oxygen supply into balance - To lower BP - the main affect are on the main vessels (unloading the heart reducing the work that the heart does) - if you dilate your arterioles you decrease the afterload allow the heart to use less oxygen because it works less - if you dilate the venous side – allow venous pool less blood to come back to the heart the heart is filled less and the lessen the work load for the failing heart - if you pool a lot thought it would limit the blood return to the heart and this is bad for the heart THIS IS A BALANCE BETWEEN SUPPLY AND DEMAND Myocardial oxygen supply and demand - Supply perfusion of the heart vascular tone of the coronary arteries Left circumflex coronary A Right coronary A Left anterior descending coronary artery Demand ventricular wall stress (preload, afterload) (venous tone [capacitance], arteriolar tone[resistance]) Relationship between vascular tone and parameters of cardiovascular physiology Vessel type Parameter of CV physiology Coronary Myocardial Oxygen supply Arterioles Afterload; myocardial oxygen demand ; regionarl mysocardial perfusion Capacitance vien Venous pooling; preload;myocardial oxygen deman - The effects of vasodilators on CV physiology can be predicted based on the vessel type of which the agents act: Coronary artery dilator increase O2 supply Arterioles dilators decreased afterload Venodilators Decrease preload Both arteriolar and venodilators decrase myocardial O2 demand Determinants of myocardial O2 consumption and pharmacologic regulation - Agents decrease O2 demand Beta adrenergic antagonists some Ca++ entry blockers (HR and
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