2: Lecture 2

Question 1

Main action of Symptomatic drugs

Answer 1

Reduce workload on the heart to reduce oxygen demand and/or improve coronary flow

Question 2

3 Classes of Symptomatic drugs

Answer 2

1) Nitrates
2) Ca2+ channel blockers
3) Beta-blockers

Question 3

Mechanism of Nitrates (symptomatic drug)

Answer 3

Vasodilator–>reduce blood pressure–>decrease diastolic blood pre-load –>reduce heart’s workload

Question 4

Mechanism of Ca2+ channel blockers (symptomatic drugs)

Answer 4

Vasodilator–>reduce venous return–>decrease diastolic pre-load –>reduce hearts workload

Question 5

Mechanism of Beta-blockers

Answer 5

Reduce force/rate of contraction of heart–>reduce work need to push blood

Question 6

Main action of Prophylactic drugs

Answer 6

Reduce plaque formation (atherosclerosis)
Used for slower developing ischemia

Question 7

Types of Prophylactic drugs

Answer 7

Lipid-lowering drugs
Anti-coagulants
Fibrinolytic drugs
Anti-platelet drugs
Dietary changes (reduction of cholesterol and lipids)
Regular moderate exercise

Question 8

3 Factors that determine oxygen demand of the heart

Answer 8

1) Contractile state
2) Heart Rate
3) Wall tension

Question 9

3 Factors that determine oxygen supply to the heart

Answer 9

1) Atrioventricular oxygen difference
2) Regional Myocardial Distribution (can be increased by exercise, the distribution of blood vessels that serve the heart muscle itself)
3) Coronary blood flow (circulation of blood in the vessels that supply the heart muscle)

Question 10

How to counteract low Coronary flow (not enough oxygen supply)

Answer 10

Vasodilators to increase blood flow

Question 11

How to counteract high oxygen requirements (high oxygen demand)

Answer 11

Vasodilator drugs and Cardiac depressants to counteract effect of increase in blood pressure and heart rate
Beta blockers to reduce work output of heart (reduce oxygen demand)