UNIT 1: CHAPTER 2: ANTIANGINAL DRUGS

Question 1

ISCHEMIC HEART DISEASE (IHD) aka

Answer 1

Aka: Coronary Artery Disease (CAD) Coronary Heart Disease (CHD)

Question 2

Is a type of heart disease that develops when the arteries of the heart cannot deliver oxygen-rich blood to the heart thereby, insufficient oxygenated blood reaches the myocardial cells.

Answer 2

ISCHEMIC HEART DISEASE (IHD)

Question 3

Is a form of paroxysmal chest pain that is felt beneath the sternum, and commonly radiates down the left arm and/or shoulder. It can also radiate or originate in the neck or upper back.

Answer 3

Angina Pectoris

Question 4

Decreased oxygenation of myocardium but the cells are still viable.

Answer 4

Ischemia

Question 5

Tissue death (necrosis) due to inadequate blood supply to the affected area

Answer 5

Infarction

Question 6

Causes of Angina Pectoris

Answer 6

1.Obstructiontocoronaryflow(atheromatous,classic angina).
2. Spasm(variantangina).
3. Others:Hypovolemia,anemia

Question 7

Blood clot sticking to coronary arteries

Answer 7

Thrombosis

Question 8

Stable Angina aka

Answer 8

•Chronic Stable Angina Pectoris (CSAP)
•Effort Angina
• Exertional Angina
• Classic Angina
• Typical Angina

Question 9

Pain is often described as tightness, heaviness, or pressure- like feeling on the chest (not a sharp pain).

Answer 9

Stable Angina

Question 10

Lasts about 2-5 minutes and can be relieved by sublingual nitrates.

Answer 10

Stable angina

Question 11

Patients place a clenched fist over their sternum when describing their symptoms

Answer 11

Levine Sign

Question 12

Most common form of angina (approx. 90%)

Answer 12

Stable Angina

Question 13

Occurs most frequently in the morning.

Answer 13

Stable angina

Question 14

Common triggers of Stable angina

Answer 14

1. Exertion
2. Emotional stress
3. Exposure to cold or hot/humid environment
4. Eating a heavy meal

Question 15

Variant angina aka

Answer 15

• Vasospastic Angina
• Prinzmetal Angina

Question 16

Coronary artery vasospasm (endothelial dysfunction/ damage or smooth muscle hyperactivity.

Answer 16

Vasospastic Angina

Question 17

Unstable angina aka

Answer 17

• Acute Coronary Syndrome (ACS)
• Rest Angina

Question 18

Often degenerates to Myocardial Infarction.

Answer 18

Unstable angina

Question 19

A sudden increase in severity, frequency, and duration of pain of ischemic episode.

Answer 19

Unstable angina

Question 20

Causes of Unstable Angina

Answer 20

1. Coronary thrombosis
2. Rupture of
   atherosclerotic plaque (complete blockade)

Question 21

Decreased by Nitrates

Answer 21

Venodilation

Question 22

Amount of blood present in ventricles prior contraction

Answer 22

Preload

Question 23

Increases by nitrates and CCBs

Answer 23

Arteriodilators

Question 24

Decreased by N-blockers and some CCB’s

Answer 24

•NON - DHP
• Verapamil
• Diltiazem

Question 25

a surgical procedure used to treat coronary heart disease.

Answer 25

Coronary artery bypass graft surgery

Question 26

Nitrates/Nitrovasodilators effects

Answer 26

1. Selective Venodilation (low doses) 2. Arteriodilation (high doses)

Question 27

Only nitrite compound used to treat angina.

Answer 27

Amyl Nitrite

Question 28

Volatile liquid administered by inhalation.

Answer 28

Amyl Nitrite

Question 29

Most rapid onset (in 30 sec.) and has the shortest DOA.

Answer 29

Amyl Nitrite

Question 30

▪ Treatment of acute angina attacks. ▪ Initial treatment of cyanide poisoning.

Answer 30

Amyl Nitrite

Question 31

▪ Sublingual → acute angina attacks ▪ Oral (SR) and transdermal → prevention of angina attacks ▪ Intravenous → AHF associated with angina and MI

Answer 31

Nitroglycerin

Question 32

Sublingual & oral for both preventive and treatment of angina attacks

Answer 32

ISDN (Isosorbide dinitrate)

Question 33

Beta Blockers drugs

Answer 33

• ATENOLOL • PROPRANOLOL • METOPROLOL

Question 34

Brand name of ATENOLOL

Answer 34

Tenormin

Question 35

Brand name of PROPRANOLOL

Answer 35

Inderal

Question 36

Brand name of METOPROLOL

Answer 36

Lopressor

Question 37

Only used in the maintenance therapy and prophylaxis of exertional angina

Answer 37

Beta Blockers

Question 38

Prevent reflex tachycardia

Answer 38

Beta Blockers

Question 39

Increases patient survival after MI

Answer 39

Beta Blockers

Question 40

CALCIUM CHANNEL BLOCKERS drugs

Answer 40

Non-DHP CCBs ( Non-dihydropyridine ) •Diltiazem •Verapamil

Question 41

DHP (Dihydropyridine) CCBs drugs

Answer 41

nifedipine, isradipine, felodipine, nicardipine, nisoldipine, lacidipine, amlodipine, and levamlodipine

Question 42

Brand name of Ranolazine

Answer 42

Ranexa

Question 43

Brand name of Trimetazidine

Answer 43

•Vestar • Vastarel

Question 44

Inhibits ketoacyl-CoA thiolase, the key enzyme in the beta-oxidation pathway of fatty acid metabolism.

Answer 44

Trimetazidine

Question 45

The effect of this drug is the reduction of fatty acid oxidation evokes compensatory increase in glucose metabolism. Glucose metabolism reduces oxygen consumption by 20%.

Answer 45

Trimetazidine

Question 46

Blocks the pathological activation or prolongation of the late inward sodium current (INa-L) in heart cells that leads to excessive intracellular sodium and calcium accumulation. Increase in intracellular calcium can lead to mechanical dysfunction, abnormal contraction and relaxation, electrical instability, afterdepolarizations, and arrhythmia.

Answer 46

Ranolazine

Question 47

It has shown to increases exercise capacity in patients with angina resulting to fewer anginal symptoms and decreased need for NTG use.

Answer 47

Ranolazine