Anti-Anginal Drugs Flashcards
Nitroglycerin is a __
nitrate
Nitroglycerin can be administered
sublingually, buccal, transdermal, and iv
What route of Nitroglycerin administration is the fastest?
Iv or sublingual
Beta Blockers used in anti-angina
propanolol, atenolol
Side effects of Beta Blockers
fatigue, hypotension, bradycardia, dizziness, bronchospasm, and heart block.
Who shouldn’t use Beta Blockers?
Individuals with bronchospasm, hypotension, bradycardia, AV block, or severe congestive heart failure
What are the actions of Calcium Channel Antagonists?
1)Vasodilation via their actions on the smooth muscle in the coronary and peripheral vasculature
2) Decrease in contractility through their actions on the cardiac myocytes
3) Decrease automaticity and conduction velocity through slowing calcium channel recovery in sinus and atrioventricular nodal cells
What 3 Calcium Channel Antagonists should you know?
Verapamil, Diltiazem, nifedipine
How do Verapamil and Diltiazem treat angina
They reduce cardiac contractility and at high doses affect AV conduction
How does Nifedipine treat angina?
It can reflex tachycardia due to systemic arterial dilation. The beneficial effects of this drug are purely due to an increase in coronary blood flow to the epicardial regions of the heart and peripheral vasodilation.
What class of drug can Nifedipine be used in combination with to treat angina?
Beta Blockers
Ranolazine has be found to be beneficial in patients with _____ angina
Chronic
Adverse effects associated with Ranolazine
dizziness, nausea, asthenia, and constipation. May increase QT interval
How does Aspirin treat angina?
At higher doses (325 mg BID) it has been shown to reduce the risk of myocardial infarction and death in patients with unstable angina
Side effects of Aspirin
GI bleeding, gastric ulceration, reduced renal function due to reduced renal blood flow, and occasional bronchospasm
How does Heparin help treat Angina?
It inhibits blood clotting.
Who should not use Heparin?
Individuals with a preexisting bleeding disorder such as a peptic ulcer
How does morphine help treat angina?
It relieves chest pain of unstable angina, especially in individuals at risk of cardiac death.
What are the two beneficial effects of morphine in the treatment of angina?
1) It’s analgesic effect relieves chest pain while it also had the ability to selectively reduce preload and afterload in patients with raised sympathetic tone
2) It causes the release of histamine from mast cells and this can contribute to its vasodilatory effects
What drugs do you use for acute attacks of angina?
S/L nitrates and nifedipine
What drugs can treat stable angina?
Beta blockers and Calcium channel antagonists. Long acting nitrates can be used orally
What can be used to treat unstable angina?
Aspirin. Nitrates, Beta Blockers and Calcium channel antagonists can be used in conjunction with aspirin
