Anti-Anginal Medications Flashcards
common markers for myocardial infarction
CK-MB
troponin T and I
stable angina
lumen narrowed by plaque
unstable angina
plaque rupture
platelet aggregation
thrombus formation
variant angina (prinzmetal)
no overt plaques
intense vasospasm
malfunctioning of NO mediated vasodilation
microvascular angina
impairment of micro vessels due to imbalance in neural factors
endothelial factors
myogenic contribution
metabolic stress
High potency nitrates
GTN/Nitroglycerin
Pentaerythritol tetranitrate
low potency nitrates
ISMN isosorbide mononitrate
ISDN isosorbide dinitrate
MOA of high potency nitrates under low dose
bioactivated by mitochondiral aldehyde dehydrogenases to form nitrite
- nitrite with mitochondiral cytochomr oxidase or xanthine oxidase get converted to NO
Nitrates NO release can be used for
unstable angina
AE of nitrates
nitrates rxt with hemoglobin to form methemoglobin leading to pseudocyanosis
tolerance for nitrovasodilators
excess reactive oxygen species can down regulate NO by converting them to peroxynitrite levels
Ranolazine - Inward Na current/channel inhibitor
inhibits inward Na channel decreases the excess Na load which prevents Ca overload and reduces myocardial oxygen demand
contraindications of ranolazine
ppl with pre-existing QT prolongation as it can lead to torsade de pointes and ventricular tachyarrhythmia
Ivabradine (MOA and AE)
inibition of Na entry (inward funny current) through HCN in
SA node
- bradycardia, atrial fibrillation, visual disturbances
ca channel blocker AE
- bradycardia, asystole and exacerbation of heart failur
