2 Angina and Arrhythmia Flashcards
What is angina?
Angina is pain that occurs in the chest
region during ischemic heart disease.
What are the 3 types of organic nitrates? Which would you use for an acute attack?
• Nitrogliycerine* acute
- Isosorbide Dinitrate
- Isosorbide Mononitrate
How do organic nitrates work?
Dilate systemic vascular system to decrease preload of the heart
By dilating the systemic peripheral
arterioles, they decrease afterload on the heart
A decrease in cardiac preload and
afterload decreases the amount of work the heart must perform, and myocardial oxygen demand decreases
What are the side effects of organic nitrates?
- Headache
- Dizziness
- Orthostatic hypotension
- Nausea
- tolerance
What are the side effects of calcium channel blockers?
• Headache • Flushing – feeling of warmth • Dizziness • Peripheral edema • Nausea • Increase risk of cancer • “ipine” – rapid ↓ in peripheral vascular resistence and BP
What is stable angina?
Ischemia has a known onset.
Cause and effect.
What is variant angina?
Vasospasm when you get up in the morning.
aka: prinzmetal ischemia
What is prinzmetal ischemia?
Vasospasm when you get up in the morning.
aka: variant angina
What is an unstable angina?
Has no known cause, seems random in onset
Which type of arrhythmia is life threatening?
Ventricular
How many classes of antiarrhythmia drugs are there?
4
- Class I : Sodium channel blockers – Subclass A-C
- Class II: Beta blockers
- Class III: Drugs that prolong repolarization
- Class IV: Calcium channel blockers
What is the mechanism of action for class I antiarrhythmia drugs?
• these drugs bind to membrane sodium
channel in excitable tissue in the myocardium
- Normalize the rate of sodium entry into and normalize the rate of cardiac cell firing
- Helps to stabilize the cardiac cell membrane
Class 1A Antiarrhythmia drugs
• Produce a slowing of depolarization and
action potential throughout the myocardium
• Prolong repolarization of the cardiac cell
Class IB antiarrhythmia drugs
• Minimal ability to slow depolarization and
cardiac conduction
• Shorten cardiac repolarization
• Drugs are primarily used to treat ventricular arrhythmias – V-tach and PVC’s
Class IC antiarrhythmia drugs
- Decrease the rate of depolarization and cardiac conduction
- Have little effect on repolarization
- Used to treat ventricular arrhythmias – V-tach and PVC’s