Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Drug Mech Final > Angina > Flashcards

Angina Flashcards

1
Q

What is the primary cause of angina?

A

an imbalance between the oxygen requirement of the heart and the oxygen supplied to it via the coronary vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Initial drug therapy of angina involves the use of:

A
  • Organic nitrates
  • CCBs
  • Beta blockers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What can be done to increase oxygen to ischemic tissue if reduction of oxygen demand does not control the symptoms of angina?

A
  • Coronary bypass grafts

- Angioplasty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Name the Nitrate

A

Nitroglycerin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

True or False: Nitroglycerin dilates both arteries and veins

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the MOA of nitroglycerin?

A

Denitrated by glutathione S-transferase resulting in a free nitrite ion which is then converted to NO leading to activation of GC which will increase cGMP which causes vasodilation—the vasodilation decreases arterial pressure, venous return, and intracardiac volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Name the toxicities of Nitroglycerin

A
  • Orthostatic hypotension
  • Reflex tachycardia
  • Throbbing headache
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Nitroglycerin is contraindicated if

A

cranial pressure is elevated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Dilation of the epicardial coronary arteries causes a(n) (increase or decrease?) in coronary artery spasm, platelet aggregation, and myocardial oxygen demand

A

decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What route of administration works the fastest but has a brief duration of action?

A

sublingual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Longer duration of action is achieved with:

A
  • Oral
  • Transdermal slow release preparations
  • IV infusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What drugs are contraindicated with the use of Nitrates?

A

PDE-5 inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Continuous exposure to nitrates causes ______

A

tolerance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

True or False: Continuous exposure causes tolerance due to diminished NO release or systemic compensatory mechanisms

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

All CCBs tht are currently used in therapeutics are (R or L) type CCB?

A

L-type

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What type of CCB is the dominant type in cardiac smooth muscle?

A

L-type

17
Q

Although CCBs block calcium channels in most types of smooth muscle, _________ smooth muscle appears to be the most sensitive

A

vascular

18
Q

Which CCB was the first clinically useful member of this class of drugs?

A

Verapamil

19
Q

Which CCB is from the dihydropyridine family of CCBs?

A

Nifedipine

20
Q

What is the MOA of CCBs?

A

Bind to the L-type calcium channel on the inside of the membrane reducing the frequency of opening in response to depolarization causing a marked decrease in transmembrane calcium influx

21
Q

How does the MOA of CCBs affect vascular smooth muscle?

A

leads to a long-lasting relaxation of vascular smooth muscle, vasodilation, and reduction in BP

22
Q

How does the MOA of CCBs affect cardiac muscle?

A

leads to a reduction in contractility, LV wall stress, SA node rate, and AV node conduction velocity leading to a reduction in myocardial oxygen requirements

23
Q

Name the toxicities of CCBs

A
  • Cardiac depression
  • Cardiac arrest
  • Bradycardia
  • AV block
  • Heart failure
24
Q

Reflex tachycardia in response to hypotension occurs more often with

A

Nifedipine

25
Q

Which CCBs cause significant myocardial depression and exhibit an antiarrhythmic effect?

A

Verapamil

Diltiazem

26
Q

Patients who are taking ___________ are more sensitive to the cardiodepressant effects of CCBs

A

beta-blockers

27
Q

What is the MOA of Beta-blockers in the management of angina?

A

decrease myocardial oxygen requirements, both at rest and during exercise, by decreasing heart rate, BP, and contractility

28
Q

Are beta-blockers vasodilators?

A

no

29
Q

Undesirable effects of the Beta-blockers in angina include a(n) (increase or decrease?) in diastolic volume, which is associated with a(n) (increase or decrease?) in myocardial oxygen requirements

A

increase; increase

30
Q

What are some contraindications of beta-blockers?

A
  • Asthma and other bronchospastic conditions
  • Severe bradycardia
  • AV blockade
  • Severe left ventricular failure
31
Q

The undesirable effects of the beta-blockers can be balanced by the concomitant use of

A

nitrates

32
Q

What is the indication of Ranolazine?

A

treatment of chronic angina in patients who have not achieved an adequate response with other antianginal drugs and have no other treatment alternatives

33
Q

Which drugs are contraindicated with the use of Ranolazine?

A

Diltiazem

Verapamil

34
Q

What is the MOA of Ranolazine?

A

Inhibits the late inward sodium current leading to reduction in intracellular calcium sodium levels, reversal of calcium overload, restoration of ventricular pump function, and prevention of ischemia-induced arrhythmias

35
Q

Name the toxicities of Ranolazine

A
  • Prolonged QT interval
  • Constipation
  • Nausea
  • Dizziness
36
Q

Ranolazine is a substrate for

A

CYP3A4

37
Q

Ranolazine should not be used with inhibitors of CYP3A4, which could (increase or decrease?) its serum concentrations and QTc interval prolongation

A

increase

38
Q

True of False: Ranolazine is contraindicated in patients with QT prolongation or hepatic impairment?

A

True

39
Q

What type of drugs are contraindicated with the use of Ranolazine?

A

drugs that prolong the QTc interval

Drug Mech Final (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions