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CVD > 11. Anti-Angina Drugs > Flashcards

11. Anti-Angina Drugs Flashcards

1
Q

What is variable angina caused by?

A

Stress

Coronary artery spasm

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2
Q

What are the ABCDEs of the treatment of stable angina?

A 
Aspirin and antianginal therapy
Beta blocker and blood pressure
Cigarette smoking and cholesterol
Diet and diabetes
Education and exercise
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3
Q

What drugs are used in the treatment of angina?

A

Nitrates
Beta blockers
Ca channel blockers

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4
Q

When are ACE inhibitors indicated?

A

Diabetes
Hypertension
Chronic kidney disease
LV dysfunction

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5
Q

How do nitrates work?

A

Prodrugs which are converted to nitric oxide

Cause a reduction in intracellular Ca, resulting in vasodilation

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6
Q

What does a low dose of nitrates cause?

A

Reduction in pre-load, reducing the work of the heart

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7
Q

What does a high dose of nitrates cause?

A

Vasodilation of coronary arteries

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8
Q

What issue is associated with the prescription of nitrates?

A

Tolerance develops quickly: a nitrate free period must be provided every 24 hours

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9
Q

What methods of delivery can be used for nitrates?

A

Sublingual
PO
Cutaneous
IV

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10
Q

What side effects are associated with nitrates?

A

Headache, hypotension

Interact with phosphodiesterase 5 inhibitors causing severe hypotension

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11
Q

How do beta blockers work?

A

Block action of adrenaline and noradrenaline on B1-adrenergic receptors (cardioselective)
Reduce oxygen demand by decreasing HR, BP, contractibility

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12
Q

What is the effect of B1 receptors?

A

Increase heart rate and contractability

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13
Q

What is the effect of B2 receptors?

A

Dilate blood vessels and bronchi

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14
Q

What is the effect of a1 receptors?

A

Vasoconstriction

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15
Q

What are the side effects of beta blockers?

A 
Bronchoconstriction
Bradycardia
Precipitate heart failure
Exacerbate peripheral vascular disease
Alter lipid profile
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16
Q

What are the uses of beta blockers?

A

Angina
MI
Heart failure
Arrhythmias

17
Q

Name a non-selective beta blocker

A

Propanolol for tremor

Timolol for glaucoma

18
Q

Name a cardioselective beta blocker

A

Atenolol

19
Q

Name an alpha 1 antagonist

A

Carvedilol for heart failure

20
Q

How do calcium channel blockers work?

A

Block L-type ca channels

Reduces intracellular calcium, causing smooth muscle relaxation (vasodilation and decrease in heart contractibility)

21
Q

What are the classes of calcium channel blockers?

A

Dihydropyridines (work on vessels)

Non-dihydropyridines (work on heart)

22
Q

What side effects are associated with calcium channel blockers?

A 
Hypotension
Oedema
Bradycardia
Precipitate heart failure
Constipation
23
Q

What are the clinical uses of calcium channel blockers?

A

Arrhythmias
Hypertension
Angina

CVD (22 decks)

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