Anti-Anginal Drugs

Question 1

Nitroglycerin is a __

Answer 1

nitrate

Question 2

Nitroglycerin can be administered

Answer 2

sublingually, buccal, transdermal, and iv

Question 3

What route of Nitroglycerin administration is the fastest?

Answer 3

Iv or sublingual

Question 4

Beta Blockers used in anti-angina

Answer 4

propanolol, atenolol

Question 5

Side effects of Beta Blockers

Answer 5

fatigue, hypotension, bradycardia, dizziness, bronchospasm, and heart block.

Question 6

Who shouldn’t use Beta Blockers?

Answer 6

Individuals with bronchospasm, hypotension, bradycardia, AV block, or severe congestive heart failure

Question 7

What are the actions of Calcium Channel Antagonists?

Answer 7

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

Question 8

What 3 Calcium Channel Antagonists should you know?

Answer 8

Verapamil, Diltiazem, nifedipine

Question 9

How do Verapamil and Diltiazem treat angina

Answer 9

They reduce cardiac contractility and at high doses affect AV conduction

Question 10

How does Nifedipine treat angina?

Answer 10

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.

Question 11

What class of drug can Nifedipine be used in combination with to treat angina?

Answer 11

Beta Blockers

Question 12

Ranolazine has be found to be beneficial in patients with _____ angina

Answer 12

Chronic

Question 13

Adverse effects associated with Ranolazine

Answer 13

dizziness, nausea, asthenia, and constipation. May increase QT interval

Question 14

How does Aspirin treat angina?

Answer 14

At higher doses (325 mg BID) it has been shown to reduce the risk of myocardial infarction and death in patients with unstable angina

Question 15

Side effects of Aspirin

Answer 15

GI bleeding, gastric ulceration, reduced renal function due to reduced renal blood flow, and occasional bronchospasm

Question 16

How does Heparin help treat Angina?

Answer 16

It inhibits blood clotting.

Question 17

Who should not use Heparin?

Answer 17

Individuals with a preexisting bleeding disorder such as a peptic ulcer

Question 18

How does morphine help treat angina?

Answer 18

It relieves chest pain of unstable angina, especially in individuals at risk of cardiac death.

Question 19

What are the two beneficial effects of morphine in the treatment of angina?

Answer 19

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

Question 20

What drugs do you use for acute attacks of angina?

Answer 20

S/L nitrates and nifedipine

Question 21

What drugs can treat stable angina?

Answer 21

Beta blockers and Calcium channel antagonists. Long acting nitrates can be used orally

Question 22

What can be used to treat unstable angina?

Answer 22

Aspirin. Nitrates, Beta Blockers and Calcium channel antagonists can be used in conjunction with aspirin