Anti-angina Flashcards
Nitroglycerin
Organic Nitrate
Isosorbide Mononitrate
Organic nitrate
Use: oral prophylaxis of angina
PK:
Sildenafil
MOA: inhibits PDE5
Effect: prolongs action of cGMP = venodilation
Use: erectile dysfunction, angina, HF, and pulmonary HTN
Sodium Nitroprusside
MOA: direct NO donor Effect: immediate vasodilator Use: HTN emergency and severe HF PK: t1/2 < 3min SE: reflex tachycardia, hypotension (OD), rare cyanide toxicity**
Nifedipine / Amlodipine
L-type Ca2+ channel blockers (dihydropyridines)
CI: not indicated unless combined w/ β-blocker
Verapamil
L-type Ca2+ channel blocker (non-dihydropyridine)
MOA: acts on cardiac smooth muscle
Effect: slows AV nodal conduction to decrease HR, contractility, BP and O2 demand
Use: arrhythmias, prizmental angina
SE: constipation
Diltiazem
L-type Ca2+ channel blocker (non-dihydropyridine)
MOA: acts on cardiac smooth muscle
Effect: slows AV nodal conduction to decrease HR (not as good as Verapamil), contractility, BP and O2 demand
Ranolazine
Na+ channel blocker
Mechanism:
Action: 👇🏽contractility, 👇🏽O2 demand, (may modify FA oxidation)
Use: prophylaxis for pts when all other anti-anginal therapies fail
PK: metabolized by CYP3A4
SE: prolonged QT, nausea, constipation, dizziness
Contra: pts w/ prolonged QT, Torsade’s de Pointes, and V-tach
Isosorbide Mononitrate
MOA: vasodilation
Use: oral used for long-term prophylaxis of angina, HF tx to decrease preload (used as adjunct w/ Hydralazine)
Aspirin
Antiplatelet agent
Metoprolol / Atenolol
β1-blockers (cardioselective)
Effect: reduce HR, contractility, O2 demand
Use: decrease frequency and severity of angina attacks
SE: bradycardia, impotence
Propranolol
β1 and β2 blocker
Effect: reduce HR, contractility, O2 demand
Use: decrease frequency and severity of angina attacks
SE: bradycardia, bronchoconstriction, impotence
CI: variant (prinzmental) angina
