anti-anginal therapy

Question 1

propanolol, atenolol, matoprolol

Answer 1

B-adrenoceptor antagonists

• blocks NA and A from acting on heart
• reduces cardiac work, reduces oxygen demand, improves coronary blood flow, used in prophylaxis of angina

Question 2

aspirin

Answer 2

• treatment of unstable angina

- anti-platelet drug

Question 3

glycerol nitrate

Answer 3

- organic nitrate
SE: flushing, light headedness, postural hypotension
- nitroglycerin
- extensive first pass metabolism
- rapid onset of action
- treating anginal attacks

Question 4

isosorbide dinitrate and isosorbide mononitrate

Answer 4

-organic nitrate
SE: flushing, light headedness, postural hypotension
-greater resistance to metabolism than glycerol nitrate
-oral administration
-slow onset of action
-prevention of anginal attacks

Question 5

Nicorandil

Answer 5

-potassium channel opener
-increase opening of K ion channels
-hyper-polarisation of cell thus decrease Ca entry, causing a direct relaxation of vascular smooth muscle
-hybrid potassium channel opener and nitrate as well
-also activates guanylate cyclase
SE: due to peripheral vasodilation

Question 6

verapamil, diltiazem, nifedipine, amlopdipine

Answer 6

-CCB
-negative inotropic and chronotropic effects on heart cells
-relaxes arterial smooth muscle
-A) nodel cells–> Ca entry at pacemaker slope causing initiation of action potential, when Ca channel is blocked a negative chronotropic effect occurs
-B) cardiac muscle cells–>Ca entry during platuea causes a contraction, when Ca channel is blocked a negitive inotropic effect occurs
-NET EFFECT is decreased oxygen demand
Nifedipine and amlopdipine have only vascular effects, whilst diltiazem and verapamil and antiarrhythmics