CVR 28 Antianginals Flashcards
What is angina
mismatch between oxygen supply and demand
angina pectoris
mismatch myocardial oxygen supply and demand
Unstable angina is
abrupt pattern change
Clinical Symptoms of angina
retrosternal discomfort, pressure like, releived by rest, radiate down arm and neck
Describe the histology of a normal arterial wall
The normal artery consists of three distinctive layers: the intima, the innermost layer comprising a single layer of endothelial cells on the luminal surface; the media, a tube of vascular smooth muscle cells (VSMCs) and their extracellular matrix; and the adventitia, the outer protective layer comprising loose connective tissue containing blood vessels and nerves which supply the artery itself.1,2
Initial Rx of patients with stable angina?
Aspirin and antianginal therapy
Drugs used in treatment of angina
nitrates, beta adrenergic antagonists, calcium channel blockers
ACE inhibiters are indicated by?
diabetes, hypertension, chronic kidney disease, left ventricular dysfunction
What do organic nitrates do?
Through oxidising to NO they increase cGMP which activates protein kinases and decreases intracellualar calcium and relaxes the smooth muscle which decreases pre load and vasoldilation
What is stable angina
no change in symptoms over previous weeks
Unstable angina
abrupt pattern change
What are the layers of a normal artery
intima innermost, the media a tube of smooth muscle, adventitia the outer protective layer of loos connective tissue containing blood vessels.
How is it thought thought atherosclerosis comes about?
The primary event in atherosclerosis is thought to be damage caused to the endothelium of arterial walls, resulting in endothelial dysfunction.
What is the initial Rx of patients with stable angina
A - aspirin B - beta blocker and BP C - smoke and cholestorol D - diabetes and diet E - education and exercise
What are drugs used in angina
nitrates
beta adrenergic antagonist
calcium blockers
