Anti Angina Therapy Flashcards Preview

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Flashcards in Anti Angina Therapy Deck (14):
1

What are the approaches for treating Angina?

1.Increase coronary Blood flow
2.Reduce Myocardial Oxygen consumption
-reduce HR
-reduce contractility
-decrease ventricular workload
-reduced preload
-reduced afterload
Prevent platelet deposition and aggregation

2

Which vessels do Nitrates dilate?

Both veins and coronary arteries and systemic arteries decreasing preload and afterload

3

What does Nitric Oxide do?

Essentially it activates an enzyme called Guanylyl Cyclase which increases cGMP which acts on Protein kinase G which cause SM relaxation

4

What are the hemodynamic effects of Nitrate administration?

1.BP unchanged or slight decrease
2.HR unchanged or slight increase
3.Pulmonary vascular resistance decreased
4.Slight CO reduction

5

What are the adverse side effects of Nitrates?

Hypotension (higher doses)
Reflex tachycardia (may worsen angina)
Orthostatic Hypotension
Syncope
Headache
Drug rash

6

What drugs are absolutely contraindicated with Nitrates?

ED drugs like Sildenafil and other type V PDE inhibitors,

7

What is the hepatic enzyme responsible for metabolising nitrates

Gluthathione-organic nitrate reductase

8

What is the major disadvantage of oral administration of nitrates?

Extensive first pass hepatic metabolism

9

What happens with continuous Nitrate exposure?

Loss of efficacy, Tolerance

10

How would one counter tolerance?

Have nitrate free periods of the day or take only upon ssymptoms

11

What happens if nitrates are suddenly interrupted?

Anginal rebound which would lead to coronary Vasospasm

12

What class of drug would you combine with Dihydropyridine in the treatment of Angina?

A beta-blocker

13

What drug would you not combine a beta-blocker with in the treatment of Angina?

Non-Dihydropyridine i.e Verapamil and Diltiazem

14

In which type of Angina do you not use b-blockers?

Vasospastic