Angina Flashcards
What are the 2 types of angina
- Stable angina
- Unstable angina (emergency)
In terms of symptom, what are the differences between the 2 types of angina and what is the main symptom of angina
Stable
- Predictable pain on exertion
Unstable angina
- Unpredictable pain on both exertion and rest
Main symptom= chest pain
What is the first line treatment for stable angina and what drug class is it in?
Glyceryl trinitrate
Drug class: Nitrates
What is the mechanism of action for glyceryl trinitrate
- Glyceryl trinitrate releases nitric oxide
- Nitric oxide binds to soluble guanyl cyclase
- This inhibits the release of ca2+ from the sarcoplasmic reticulum
- Which inhibits vasoconstriction and causes vasodilation in Vascular smooth muscles
What are the counselling points for glyceryl trinitrate
- Use immediately upon symptoms and before planned exercise
- Sit/ lie down before using as drug causes a drop in blood pressure
- Hold spray upright and spray 1-2 under tongue
- Close mouth
- Repeat dose after 5 mins if pain not subsidised
- Call 99 if pain has not gone 5 mins after 2nd dose
What drug class does nicorandil belong to
Potassium channel activators
What is the mechanism of action for nicorandil
- Opens ATP sensitive K+ channels
- Stimulates guaynyl cyclase to release cGMP
- Leads to dilation of vascular smooth muscle
hmm missing some info lets see
What drug class does Ivabradine belong to
HCN Channel blockers - double check
What is the mechanism of action for Ivabradine
- Blocks funny current channels in the SAN
- Helps slow down heart rate and reduces cardiac workload therefore reducing angina symptoms
What drug class does ranolazine belong to
Anti-angina - doble check
What is the mechanism of action for ranolazine
- Blocks late sodium currents in cardiac myocyte
- Reduces accumulation of sodium and calcium inside the cell
- Decreases oxygen demand and improves efficient of hearts energy
