Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

UNMC PA Pharmacology > Anti-Anginals and ED Drugs > Flashcards

Anti-Anginals and ED Drugs Flashcards

1
Q

Classes of drugs used for angina

A

Organic nitrates
Calcium channel blockers
Beta blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Main mechanism/goal of anti-anginal drugs

A

Reduce myocardial oxygen demand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Factors that determine myocardial oxygen demand

A

Heart rate
Contractility
Ventricular wall stress (preload and afterload)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Ways to reduce myocardial oxygen demand

A

Reduce preload or afterload
Reduce heart rate and contractility
Shift cardiac energy metabolism from oxidation of fatty acids to use of glucose (anaerobic metabolism)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Factors that determine myocardial oxygen supply

A

Arteriolar dilation of coronary blood flow
Duration of diastole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Ways to increase myocardial oxygen supply

A

Reduce heart rate
Dilate coronary arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Prototype organic nitrate drug

A

Nitroglycerin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Nitroglycerin MOA

A

Prodrug that releases NO when metabolized by ALDH-2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Effect of nitroglycerin on heart

A

Dilates veins to decrease venous return and decrease preload to reduce oxygen demand
Modest dilation of large epicardial arteries to increase blood flow to regions of ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When is nitroglycerin used?

A

Prophylaxis and termination of acute a final attacks
Improves exercise tolerance
No survival benefit or prevention of MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Patient population that may not be able to metabolize nitroglycerin well due to ALDH-2 polymorphism

A

Patients of Asian origin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Fast acting route of administration of nitroglycerin

A

Sublingual (1-2 minutes, lasts less than 1 hr)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Tolerance to organic nitrates is more common with what route of administration

A

Oral and transdermal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How to minimize nitroglycerin tolerance

A

Eccentric dosing (nitrate-free intervals of 10-12 hours)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Adverse effects of nitroglycerin

A

Headaches
Facial flushing
Orthostatic hypotension
Reflex tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Nitroglycerin drug interactions

A

Vasodilators
Alcoho;

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Two subclasses of calcium channel blockers

A

Dihydropyridines
Heart-rate lowering

18
Q

Dihydropyridine drug

A

Nifedipine

19
Q

Heart-rate lowering calcium channel blocker drug

A

Verapamil

20
Q

MOA of calcium channel blockers

A

Block intake of Ca2+ through voltage gated L-type calcium channels by binding to sites on the alpha 1 subunit
Vasodilators of peripheral and coronary arteries to decrease afterload and oxygen demand

21
Q

When are calcium channel blockers used for angina?

A

Prophylaxis

22
Q

Nifedipine acts mostly on what kind of tissue?

A

Vascular smooth muscle

23
Q

Verapamil acts mostly on which tissues?

A

SA and AV nodes

24
Q

Nifedipine has many drug interactions because it is metabolized by CYP___

A

CYP3A4

25
Q

Verapamil contraindications

A

Sick sinus syndrome
AV nodal block

26
Q

clinical uses of calcium channel blockers

A

Angina
Hypertension
Arrhythmias

27
Q

Adverse effects of calcium channel blockers

A

Bradycardia in HRLs
Reflex tachycardia, headache, and flushing in DHPs
GERD

28
Q

Beta-1 selective blocker drug

A

Metoprolol

29
Q

Metoprolol MOA

A

Decrease HR, contractile force, and BP to decrease myocardial oxygen demand
And increase oxygen supply

30
Q

Goal resting HR with B-blocker

A

55bpm

31
Q

Goal exercise BP with B-blocker

A

110-120 bpm

32
Q

Angina drug that reduces mortality

A

B-blockers

33
Q

What angina drug may worsen variant angina?

A

B-blockers

34
Q

Adverse effects of B-blockers

A

MI if sudden withdrawal
Exercise intolerance
Bronchoconstriction
Sexual dysfunction

35
Q

Drug combination of anti-anginal drugs to avoid prescribing together

A

Beta blockers with HRL calcium channel blockers

36
Q

Drug class used for erectile dysfunction

A

Phosphodiesterase type 5 (PDE5) inhibitors

37
Q

PDE5 inhibitor drug

A

Sildenafil

38
Q

MOA of sildenafil

A

Selective inhibitor of PDE5 in corpora cavernosa that prolongs activity of endogenous cGMP to relax smooth muscle and increase blood flow

39
Q

When should sildenafil be taken?

A

1 hour before sexual activity

40
Q

Clinical uses of sildenafil

A

Erectile dysfunction
Pulmonary hypertension

41
Q

Adverse effects of sildenafil

A

Headache and flushing
Abnormal vision
Dyspepsia
Sudden hearing loss
Priapism

42
Q

Drug interactions with sildenafil

A

Organic nitrates
Alpha blockers

UNMC PA Pharmacology (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions