Anianginal Drugs

Question 1

Nitrates

Answer 1

1) Nitroglycerin (Glyceryl Trinitrate)

2) Isosorbide Dinitrate
3) Isosorbide Mononitrate

4) Erythrityl Tetranitrate
5) Pentaerythritol teranitrate

Question 2

All nitrates except WHAT undergoes extensive first pass metabolism ?

Importance ?

Answer 2

ISOSORBIDE MONONITRATE!

Used as Chronic prophylaxis becz of

• LD of action.
• High oral Bioavailability.

Question 3

Other name for VARIANT ANGINA

Answer 3

PRINZMETAL’S ANGINA !

Question 4

VARIANT ANGINA

CAUSE ?

Treatment?

Answer 4

☯Due to coronary vasospasm…

☯CCB+NITRATES = Better efficacy + Reduces MI incidence

Question 5

6 type of drugs used in unstable angina

Answer 5

Antiplatlet Agents 
\+ Anicoagulants 
\+ Nitrates
\+ B blockers 
\+ CCB 
\+ Statins

Question 6

When should Nitroglycerin be avoided ?

Answer 6

☯If there is HYPOTENTION

☯Patients on SILDENAFIL & TADALAFIL in past 2rhrs

Question 7

How does cyanide work ?

Answer 7

O2 carrying capacity of blood is NOT AFFECTED.

CYANIDE INHABITS CYTOCHROME OXIDASE &
PREVENTS OXYGEN UTILIZATION BY CELLS !

ANOXIA !

Question 8

How to treat cyanide poisoning ?

Answer 8

☣ Step 1 : AMYL NITRATE/SODIUM NITRATE converts HB to Meth.

☣ Step 2: Meth+cyanide = Cyano-methemoglobin.(non-toxic)

☣ Step 3: IV NA THIOSULPHATE Converts Cyanometh to Na thio-cynate (out with urine)

Question 9

Name few B-Adrenergic blockers

Answer 9

✦Propran-olol
✦Metopr-olol
✦Aten-olol
✦Tim-olol

Question 10

❤ How do B-Adrenergic blockers work ?

Answer 10

Blocks B1 receptors of ❤

Question 11

What happens when B-adrenergic blockers are used ?

Answer 11

HR+Force of Contract. ↓
⬇
Cardiac work ↓↓
⬇
Myocardial O2 consumption ↓

Question 12

Which B-Blocker should be AVOIDED ?

Answer 12

PINID-OLOL (Will worse angina !)

Question 13

B-Blocker contraindicated in…..

Answer 13

VARIANT ANGINA (becz of spasm)

Question 14

CCB- Phenylalkylamine ? 👸

Answer 14

Verapamil.

Vera a women.

Question 15

CCB- Benzothiazepine ? ❤

Answer 15

Diltiazem

Question 16

CCB Dihydropyridines ? (Di…)

Answer 16

❅Nedfedipine
❅Amlodipine

❅Nicardipine
❅Felodipine

❅Isadipine
❅Nisodipine

Question 17

How to CCB work ?

Answer 17

CCbs block voltage sensitive L-TYPE Ca2+ blockers
in ❤ & Smooth muscles.
⬇
PREVENTS ENTRY OF Ca2+ into cells
⬇
No excitation-contraction coupling in ❤ & Smooth muscles.