Vasodilators in Angina Flashcards Preview

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Flashcards in Vasodilators in Angina Deck (29)
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1
Q

HR and contractility are decreased with ___ and ____.

A

Beta-blockers and some Ca++ channel blockers

2
Q

Flow to ischemic subendocardial tissue is improved with _____, _____, and _____.

A

nitrates, Beta-blockers, and Ca++ channel blockers

3
Q

Coronary blood flow is increased with _____ and _____.

A

nitrates; Ca++ channel blockers

4
Q

Preload is decreased by _____.

A

nitrates

5
Q

Afterload is decreased by _____.

A

Ca++ channel blockers

6
Q

What does CCB stand for?

A

Ca++ channel blockers

7
Q

How do you treat Variant/Prinzmetal Angina?

A

vasodilators: nitrates and Ca++ channel blockers

8
Q

Unstable angina is ACUTELY treated with?

A

clot: aspirin, heparin, GPIIB-IIIA inhibitors, PTCA/CABG,
fibrinolytics

arrhythmia: Beta-blockers
pain: NTG, morphine

9
Q

What is the post-MI treatment?

A

ACEIs, statins, blockers, aspirin, clopidrogel (if post-stent).

10
Q

How do nitrates work?

A

converted to nitric oxide (NO) at or near the plasma membrane of vascular smooth muscle cells –> increasing cGMP–> relaxation of smooth muscle

11
Q

What is the best route for nitrate admin?

A

sublingual

12
Q

What is the t1/2 of a nitrate?

A

2-8 min

13
Q

What are some important SEs for nitrates?

A

low BP, headache, tolerance

14
Q

Name 3 Ca++ channel blockers.

A
  1. Verapamil (Calan)
  2. Diltiazem (Cardizem)
  3. Nifedipine (Procardia)
15
Q

What are these drugs?

  1. Verapamil (Calan)
  2. Diltiazem (Cardizem)
  3. Nifedipine (Procardia)
A

Ca++ channel blockers

16
Q

How do Ca++ channel blockers work?

A

Block of L-type Ca++ channels in cardiac and smooth muscle –> smooth muscle relaxation

17
Q

Which Ca++ channel blocker should NOT be used?

A

Nifedipine (Procardia)

18
Q

When are Ca++ channel blockers used?

A
  1. angina
  2. arrhythmias
  3. HTN
19
Q

What are the important SEs of Ca++ channel blockers?

A
  1. cardiac depression

2. flushing, edema, dizziness, nausea, constipation

20
Q

What is Ranolazine (Ranexa)?

A

an inhibitor of the late Na+ current

21
Q

When is Ranolazine (Ranexa) used?

A

as an add on for angina or as a sub. for beta-blockers

22
Q

Use this as an add on for angina or as a sub. for beta-blockers.

A

Ranolazine (Ranexa)

23
Q

What are some important SEs for Ranolazine (Ranexa)?

A
  1. QT prolongation

2. other CV effects (less common)

24
Q

When is a beta-blocker used for angina?

A

in stable angina with a concurrent arrhythmia or HTN

25
Q

Which beta-blocker is used in angina?

A

Metoprolol (Lopressor), atenolol

26
Q

Use this drug in a pt with stable angina with a concurrent arrhythmia or HTN.

A

Metoprolol (Lopressor) or atenolol– both beta blockers

27
Q

What is Metoprolol (Lopressor)?

A

a beta blocker

28
Q

When is Metoprolol (Lopressor) contraindicated?

A

in asthmatics or with peripheral vascular disorders

29
Q

Name 2 nitrates.

A
  1. nitroglycerin (NTG)

2. oral nitrates