anti-angina

Question 1

Nitroglycerin / Nitrostat

Answer 1

Nitrate vasodilator

for: All forms of angina. Acute releif or prophylaxis before physical activity.

MOA:Nitric oxide –> immediate vasodilation of arteries –> more blood blow to the heart. Pre load is reduced due to reduced peripheral venous tone.

SE: Headache. Hypotension. Orthostatic hypotension. Rebound tachycardia. Tolerance (with transdermal administration).

Concurrent use of Silendafil (Viagra) is containdicated due to risk of severe hypotension.”

Question 2

Isosorbide Dinitrate / Isordil

Answer 2

Long acting nitrate vasodilator

for: Angina. Prophylaxis of angina.

MOA: Similar to nitroglycerin.

SE:Headache. Hypotension. Orthostatic hypotension. Rebound tachycardia.

Concurrent use of viagra is containdicated due to risk of severe hypotension.

Question 3

Propanolol / Inderal

Answer 3

also for HTN–Non-Selective Beta Blocker

for:Angina. Post-MI. HTN. Panic attacks. Migraine headaches. Decrease infarct size in patients with acute MI.

MOA:Blocks adrenergic stimulation –> decreases heart rate, decreases oxygen demand, decreases renin release.

SE:”Hypotension. Bradycardia. Fatigue. Impotence. Bronchoconstriction.

Can cause rebound hypertension and tachycardia.”

Question 4

Atenolol / Tenormin

Answer 4

Selective (Cardiospecific) Beta Blocker

for: Angina, HTN, MI. Decrease infarct size in patients with acute MI.

MOA: B1 adrenergic blockage –> decreases heart rate and myocardial oxygen demand

SE: Hypotension. Bradycardia. Fatigue. Impotence. (Less risk of bronchoconstriction than with Propanolol.)

Question 5

Amlodopine / Norvasc

Answer 5

Ca channel blocker

for: Angina, particularly vasospastic angina. Hypertension.

MOA: Blocks Ca influx into cells –> vasodilation of cardiac and peripheral arteries –> less sympathetic-induced coronary artery spasm

SE: Flushing. Headache. Hypotension.

Question 6

Morphine Sulfate

Answer 6

Analgesic

for:”Pain relief in unstable angina or MI. Anxiolytic

MOA:Opiate receptor agonist –> potent reduction of pain and anxiety –> decreased sympathetic tone –> mild peripheral vasodilation –> mild preload reduction

SE: Respiratory depression. Severe Hypotension.