Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharmacology > 1-10 (Anti-Anginals) > Flashcards

1-10 (Anti-Anginals) Flashcards

(49 cards)

Start Studying
1
Q

____: Imbalance in myocardial oxygen demand and supply

A

Ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What three factors affect myocardial oxygen demand?

A

1) HR
2) Cardiac Contractility
3) Wall Tension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

The ____ is determine by coronary blood flow and regional/tissue specific blood flow

A

oxygen supply

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

CK-MB and Troponin T and Troponin I are common markers for what medical condition?

A

MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

True or False: Angina is a disease

A

False - angina is NOT a disease. Rather, it is a symptom of hidden cardiovascular complication (e.g CAD/Ischemic Heart Disease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the four type of angina?

A

1) Stable Angina
2) Unstable Angina
3) Variant/Prinzmetal Angina
4) Microvascular Angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which type of angina is associated with no overt plaques, but intense vasospasm?

A

Variant/Prinzmetal Angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What causes symptoms associated with Variant/Prinzmetal Angina?

A

Malfunctioning of NO mediated vasodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What type of angina is associated with plaque rupture, platelet aggregation, and thrombus formation?

A

Unstable Angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which type of angina is associated with inappropriate vasoconstriction and lumen narrowed by plaque?

A

Stable Angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the four causes of impaired microvessels, as is seen in Microvascular Angina?

A

1) Imbalance in neural factors
2) Endothelial factors
3) Myogenic contribution
4) Metabolic stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

In general, how do anti-anginal medications work?

A

1) Decrease myocardial O2 demand
2) Increase myocardial O2 supply

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

True or False: Beta blockers and calcium channel blockers can be used to treat anginas

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What type of drug class does Ranolazine belong to?

A

Inward sodium channel inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What type of drug class does Ivabradine belong to?

A

Hyperpolarization activated cyclin nucleotide gated channel inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are 3 high potency nitrates?

A

1) GTN/Nitroglycerin
2) Pentaerythritol tetranitrate (PETN)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are 2 low potency nitrates?

A

1) ISMN (Isosorbide mononitrate)
2) ISDN (isosorbide dintrate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When administered at a low dose, GTN and PETN undergo bioactivation to form nitrite. Which enzyme allows for this conversion?

A

Mitochondrial aldehyde dehydrogenases (ALDH2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When GTN/PETN are given in low dose, they are are converted to nitrite then to NO. What enzymes allow for conversion to NO?

A

Xanthine Oxidase or Mitochondrial Cytochrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When GTN/PETN are given in high doses, they are activated via: ____ , ____, and by ER residing ___ system, allow for NO production

Study These Flashcards
A

ALDH2 (mitochondrial aldehyde dehydrogenases), mitochondrial cytochrome oxidase, and P450

21
Q

What type of nitrates are known to utilize ER residing CYP 450 system to get bioactivated and release NO, irrespective of dose?

Study These Flashcards
A

Low potency nitrates (ISDN, ISMN)

22
Q

When NO is released ___ is produced, leading to production of ___ and ___ = relaxation of VSM

Study These Flashcards
A

sGC (soluble guanylate cyclase) -> cGMP -> cGK-1

23
Q

What are two systemic positive effects of nitrates?

Study These Flashcards
A

1) VSM - increase venous capacitance, reduce pre-load (decrease change of getting MI or HF)

2) Increase cGMP inside platelets, prevents aggravation (THIS PROPERTY IS MADE USE OF IN UNSTABLE ANGINA!!)

24
Q

What is the most common AE associated with nitrates and is due to the fact that nitrites associate with Hb to form methemoglobin (molecule w low O2 affinity)?

Study These Flashcards
A

Pseudocyanosis

25
Overdose of Nitrovasodilators may lead to generation of ____
ROS
26
How does excess levels of Reactive Oxidative Species affect NO and peroxynitrite levels?
Excess ROS can down regulate NO by converting NO to Peroxynitrite
27
DDI with nitrites?
PDE-5 Inhibitors
28
True or False: Nitroglycerin is known to prevent first pass metabolism of Ergotamine.
True
29
True or False: Excess ergot alkaloids can precipitate angina, should be avoided in patients on nitrites
True
30
What drug is an inward sodium current/channel inhibitor?
*Ranexa/Ranolazine
31
Myocardial Ischemia is accompanied by an increase in inward ____and ____in myocardial tissues
sodium current; sodium overload
32
How does increase inward sodium current and sodium overload in myocardial tissues, as seen in Myocardial Ischemia, affect calcium entry?
Increase Na causes increase Ca entry via Na/Ca2+ Exchanger
33
True or False: Enhanced calcium overload may increase contractility followed by a DECREASE myocardial oxygen demand
False - Enhanced calcium overload may increase contractility followed by a INCREASE myocardial oxygen demand
34
How does Ranolazine affect: - myocardial O2 demand? - ca2+ overload? - sodium load?
- REDUCED myocardial O2 demand - indirectly PREVENTS excess ca2+ overload - DECREASES excess sodium load
35
What drugs can Ranolazine be co-administered with?
Other anti-anginal drugs
36
Which anti-anginal drug is contraindicated in patients with QT prolongations? Why is it contraindicated?
Ranolazine - can lead to torsade de pointes and ventricular tachycardia
37
How does increase SA Nodal Activity affect contractility and myocardial O2 demand?
Increased SA Nodal Activity increases contractility and enhances myocardial O2 demand
38
True or False: Ivabradine is a HCN channel blocker
True
39
___ inhibits sodium entry (inward funny current_ through HCN in the SA Node with reduction in HR, leading to reduced myocardial ___ demand
Ivabradine; HCN
40
Bradycardia, A-Fib, and Visual disturbances are associated with which anti-anginal?
Ivabradine
41
In angina, calcium channel blockers bind to which subunit of the L-Type Calcium Channel? How does this affect HR, force of contraction, and vasodilation?
Alpha 1 subunit (this is the MAIN pore-forming unit of the calcium channel) - HR/force of contraction: decreases -Increased vasodilation
42
Which anti-anginal is associated with the AE of: bradycardia, asystole, and WORSENING of heart failure?
Calcium channel blockers
43
True or False: Taking anti-retroviral drugs or grapefruit with CCB's can enhance CCB toxicity
True
44
What three beta-1 blockers that are most commonly prescribed for exertional angina, prior MI, or stable/unstable angina?
1) Atenolol 2) Metoprolol 3) Bisoprolol
45
AE associated with beta-1 blockers used to treat angina?
1) Left Ventricular Dysfunction
46
True or False: Cholestyramine and Colestipol decrease absorption of beta blockers, resulting in reduced bioavailability of beta blockers
True
47
By specifically blocking beta-1 receptors in CV tissue, beta blockers lead to ____ chronotropic and inotropic effects. As a result, myocardial O2 demand and use is ____
negative; decreased
48
True or False: B1 receptors are known to regulate HCN channel activity in SA Node, along with their direct stimulatory effects on cardiac muscle
True
49
Which drugs decrease oxygen demands? A. Vasodilators B. Ranolazine C. Ivabradine
B. Ranolazine C. Ivabradine (decreases myocardial sodium levels)

Pharmacology (53 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions