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CVS pharmacology > Angina > Flashcards

Angina Flashcards

1
Q

An imbalance between myocardial O2 supply and demand

A

Angina

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2
Q

3 main drugs used in treatment of Angina

A

Organic nitrates
Beta blockers
Ca channel blockers

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3
Q

Organic nitrates

A

Nitroglycerin and isosorbide dinitrate and isosorbide mononitrate

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4
Q

There bioavailability is 10%

A

Nitroglycerin and isosorbide

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5
Q

Has higher bioavailability and long duration of action

A

Isosorbide mononitrate

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6
Q

Metabolized by liver 90%

A

Nitroglycerin and isosorbide dinitrate

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7
Q

It’s excretion is largely by kidney in the form of glucuronide

A

Isosorbide mononitrate

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8
Q

Organic nitrates roles

A

✓Smooth muscle relaxation
✓Dec O2 demand by Dec work of hear
✓Dec preload and after load
✓Inc O2 supply by increasing coronary flow
✓Spasmolytic on smooth muscle

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9
Q

Uses of organic nitrates

A

✓All type of angina
In acute Angina give nitroglycerin or isosorbide dinitrate

✓ In chronic angina give long acting preparations

✓Myocardial infarction
✓Acute heart failure
✓Acute pulmonary edema
✓Spasmolytic

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10
Q

Adverse effects of organic nitrates

A

Inc IOP and glaucoma
Facial flushing
Tachycardia
Postural hypotension
Tolerance
Coronary dependence

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11
Q

Contraindications of organic nitrates

A

✓Sildenafil
✓Hypertrophic obstructive ✓cardiomyopathy right ventricle infarction
✓Volume depletion
✓Severe aortic stenosis

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12
Q

Beta blocker drugs

A

Metaprolol and atenolol

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13
Q

Uses of beta blockers

A

Prophylactic
Myocardial infarction
Safely used with diapetes and peripheral vascular disease

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14
Q

Contraindications of Beta blocker

A

✓Variant angina
✓Should not be stopped suddenly
✓Never combine
✓Bradycardia or asthma

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15
Q

Ca channel blockers

A

Dihydropyridine
Non dihydropyridine

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16
Q

Dihydropyridine

A

Amoldipine (long acting)
Nifedipine ( short acting)

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17
Q

Non dihydropyridine

A

Verapamil
Diltiazem

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18
Q

Ca channel blocker that affects myocardium

A

Verapamil

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19
Q

Ca channel blocker that exert effect on smooth muscles

A

Amoldipine and nifedipine

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20
Q

Ca channel blocker that is intermediate in it’s action

A

Diltiazem

21
Q

Uses of Ca channel blocker

A

All types of angina

22
Q

Angina + arrhythmia we will select which drug?

A

Verapamil or diltiazem

23
Q

Favorable combination in angina+Arrhythmia case

A

Verapamil and nitrate

24
Q

Unfavorable combination in case of angina+ Arrhythmia

A

Verapamil and beta blocker

25
Q

Angina+ hypertension or Bronchial spasm what drug is the best choice?

A

Nifedipine

26
Q

Favorable combination in case of angina+hypertension or Bronchial asthma

A

Nifedipine and beta blocker

27
Q

Unfavorable combination in case of angina+hypertension or Bronchial asthma

A

Nifedipine and nitrate

28
Q

Adverse effects of non dihydropyridine

A

Bradycardia
Heart block
Hypotension
Heart failure
Constipation

29
Q

Adverse effects of dihydropyridine

A

Inc HR
Headache
Flushing
Ankle oedema

30
Q

✓Drug interactions
Verapamil lead to …

A

Decrease renal excretion of digoxin

31
Q

Drug interactions
Verapamil+ beta blockers lead to …

A

Severe cardiac depression

32
Q

Nifedipine+ nitrate lead to

A

Severe hypotension and tachycardia

33
Q

Potassium channel blocker drug is

A

Nicorandil

34
Q

A drug which is both arterial and a venous dilator

A

Nicorandil

35
Q

Adverse effects of nicorandil

A

Headache
Flushing
Dizziness

36
Q

Drug used for patients while they are waiting surgery or angioplasty

A

Nicorandil

37
Q

Metabolic modulators ( cytoprotective)

A

Na channel blocker
Trimetazidine
Ivabradine

38
Q

A drug Which is a Na channel blocker

A

Ranolazine

39
Q

Uses of ranolazine

A

In chronic angina

40
Q

Adverse effects of ranolazine

A

Headache
Dizziness
Constipation
Prolongation of QT interval

41
Q

Contraindications of ranolazine

A

With other drugs that prolong QT interval

42
Q

Drug which inhibits beta oxidation of fatty acids which enhances glucose oxidation

A

Trimetazidine

43
Q

Uses of trimetazidine

A

Stable angina
Taken orally

44
Q

Drug which inhibits the pacemaker leading to decrease cardiac pacemaker activity

A

Ivabradine

45
Q

Slowing the heart rate and allowing more time for blood to flow to the myocardium

A

Ivabradine

46
Q

Drugs that decrease after and preload by arteriodilation

A

Ca channel blocker
Nifedipine and amoldipine

47
Q

By venodilation

A

Nitrates

48
Q

Coronary vasodilation

A

Nitrates
Ca channel blocker : nifedipine and amoldipine

49
Q

Opening of collaterals and redistribution of blood to ischemic ares

A

Nitrates

CVS pharmacology (7 decks)

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