Drugs For IHD Flashcards
(16 cards)
Name types of drugs for IHD
Nitrates, beta blockers, calcium channel blockers and ivabradine
Drug for acute angina
Nitroglycerin (glyceryl trinitrate)
PK of nitroglycerin
Sublingual 1-5 min onset of action 10-30 min duration
Transdermal 30-60 min onset 7-10h duration
PK of isosorbide dinitrate
Oral 60 min onset 8-12h action
PK for ISMN
Oral 30-45min onset 6-24h duration.
ISMN/ISDN clinical use
Angina pectoris prophylaxis or treatment of HF
Side effects nitrates
Reflex tachycardia, hypotension, meninges artery vasodilation causing headache
How does beta blockers help with angina
Decrease rate and contractility of heart reducing cardiac oxygen requirements
Ranking of effect of calcium Channel blockers
Lowering BP: Vasodilator: Cardiac depressant: Verapamil=diltiazem=nifedipine Nifedipine>diltiazem>verapamil Verapamil>diltiazem>Nifedipine
Side effect of calcium channel blockers
Cardiac depression: bradycardia, AV blocker, heart failure
Clinical use DHP
- Hypertension 2. Stable angina (Amlodipine) 3. Reduce risk of myocardial infarction & stroke (Amlodipine)
Name DHP
Nifedipine, amlodipine
Name Non-DHP
Verapamil, diltiazem
Side effect DHP
- Hypotension 2. Heart failure 3. Myocardial infarction
Who can use ivabradine
Stable angina pectoris cuz it is a pure heart rate lowering agent. It is also indicated for chronic heart failure with systolic dysfunction, in patients in sinus rhythm and whose heart rate is ≥ 75 bpm. Specific inhibition of cardiac pacemaker I(f) current that controls spontaneous depolarisation of sinus nodes and regulates heart rate.
Adverse effects of ivabradine
Visual problems: Luminous phenomena, transient enhanced brightness in a limited area of the visual field • Otherbradycardia associated symptoms (hypotension, fatigue, malaise)
