Angina - Medications

Question 1

Nitrates - first line for ? ? is ? GTN spray

• sit down, ? and spray ? beneath tongue, wait for ? then spray again if still pain - if still at ? then call 999 and unlock the door
• can also use ? angina provoking activity
• they reduce ? to heart by causing ?
• can cause venous ? on standing -> ? hypotension and ?
• also affect large muscular aa -> reduce ? pressure and cardiac ?, they also dilate ? vessels
• reduced pre-and-after-load decreases ? req of myocardium -> coronary ? leads to increased ? delivery
• also relieve coronary artery spasm in ? angina

Answer 1

Sx relief
sublingual
rest
once
5m
10m
before
preload
venorelaxation
pooling
postural
dizziness
aortic
afterload
coronary
o2
dilation
o2
prinzmetal

Question 2

BBs
B1 adrs mostly on ?, acting to incr ? and ?
B2 adrs cause ? ? relaxation in many organs eg trachea

in IHD - ? selective BBs used to ? cardiac rate and force (due to reduced myocardium ? consumption) with as little ? constrictive effect as possible

they also have an anti-? effect by reducing cardiac ? and decrease ? release from juxta-glomerular cells

they also have class two anti-? effects

Answer 2

heart
SV + HR
SM
B1
reduce
o2
broncho
HTN
output
renin
arrhythmic

Question 3

BBs SE

• ? - CId in ? caution in COPD
• cardiac depression/? - can be critical if combined with other ? limiters
• ? - impair the ? warning signs of ?’s
• fatigue

Answer 3

bronchoconstriction
asthma
brady
rate
hypose
sympathetic
hypose

Question 4

CCBs
dihydropyridines (amlodipine/?) or RL agents (verapamil/?)
all prevent ? ? contraction, reducing ? and causing ? vasodilatation
RL agents also on ??? to control the ??

SE - ? and headache (as with all ?), ? swelling and constipation (GI SM ?)

first line in ? angina

Answer 4

nifedipine
diltiazem
SM
afterload
coronary
AVN
HR
flushing
vasodilators
ankle
inhibition
prinzmetal

Question 5

Nicorandil

causes marked ? - used in ? angina

Answer 5

vasodilation

refractory