Flashcards in Vasodilators in Angina Deck (29)
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1
HR and contractility are decreased with ___ and ____.
Beta-blockers and some Ca++ channel blockers
2
Flow to ischemic subendocardial tissue is improved with _____, _____, and _____.
nitrates, Beta-blockers, and Ca++ channel blockers
3
Coronary blood flow is increased with _____ and _____.
nitrates; Ca++ channel blockers
4
Preload is decreased by _____.
nitrates
5
Afterload is decreased by _____.
Ca++ channel blockers
6
What does CCB stand for?
Ca++ channel blockers
7
How do you treat Variant/Prinzmetal Angina?
vasodilators: nitrates and Ca++ channel blockers
8
Unstable angina is ACUTELY treated with?
clot: aspirin, heparin, GPIIB-IIIA inhibitors, PTCA/CABG,
fibrinolytics
arrhythmia: Beta-blockers
pain: NTG, morphine
9
What is the post-MI treatment?
ACEIs, statins, blockers, aspirin, clopidrogel (if post-stent).
10
How do nitrates work?
converted to nitric oxide (NO) at or near the plasma membrane of vascular smooth muscle cells --> increasing cGMP--> relaxation of smooth muscle
11
What is the best route for nitrate admin?
sublingual
12
What is the t1/2 of a nitrate?
2-8 min
13
What are some important SEs for nitrates?
low BP, headache, tolerance
14
Name 3 Ca++ channel blockers.
1. Verapamil (Calan)
2. Diltiazem (Cardizem)
3. Nifedipine (Procardia)
15
What are these drugs?
1. Verapamil (Calan)
2. Diltiazem (Cardizem)
3. Nifedipine (Procardia)
Ca++ channel blockers
16
How do Ca++ channel blockers work?
Block of L-type Ca++ channels in cardiac and smooth muscle --> smooth muscle relaxation
17
Which Ca++ channel blocker should NOT be used?
Nifedipine (Procardia)
18
When are Ca++ channel blockers used?
1. angina
2. arrhythmias
3. HTN
19
What are the important SEs of Ca++ channel blockers?
1. cardiac depression
2. flushing, edema, dizziness, nausea, constipation
20
What is Ranolazine (Ranexa)?
an inhibitor of the late Na+ current
21
When is Ranolazine (Ranexa) used?
as an add on for angina or as a sub. for beta-blockers
22
Use this as an add on for angina or as a sub. for beta-blockers.
Ranolazine (Ranexa)
23
What are some important SEs for Ranolazine (Ranexa)?
1. QT prolongation
2. other CV effects (less common)
24
When is a beta-blocker used for angina?
in stable angina with a concurrent arrhythmia or HTN
25
Which beta-blocker is used in angina?
Metoprolol (Lopressor), atenolol
26
Use this drug in a pt with stable angina with a concurrent arrhythmia or HTN.
Metoprolol (Lopressor) or atenolol-- both beta blockers
27
What is Metoprolol (Lopressor)?
a beta blocker
28
When is Metoprolol (Lopressor) contraindicated?
in asthmatics or with peripheral vascular disorders
29
