Antianginal Flashcards
Principles of treatment of CCS
Use of antiischemic or antianginal agents and prevention of adverse cardiovascular event
No donors
Glyceril trinitrate,isosorbide mononitrate
1st gen beta Andre preceptor antagonist
Propranalol
Non dihydropiridine calcium channel blockers
Verapamil, diltiazem
Late Na flow inhibitor
Ranolazine
Sinoatrial node inhibitor
Ivabradine
Hypolipidemic agents are
Atorvastatin,fenofibrate,ezetimibs,evolozumab
Drugs used for prevention of adverse cardiovascular event
Hypolipidemic agents,RAAS, antiplatelet,ACE inhibitor,ARB
Cause of angina
Disrupted balance of oxygen supply and consumption
To reduce angina
Reduce oxygen consumption or increase oxygen supply
Oxygen demand increases when
Increase in HR, Contractions,wall tension, Preload ,afterload
Decrease oxygen supply due to
Decreased vessel caliber,perfusion pressure and increased HR, ventricular wall tension
Oxygen consumption can be reduced through
Reduced preload, afterload and CMV
Increased oxygen supply can be done through
Coronary blood vessel dilation, negative chronotropy
Negative chronotropy gives
Prolonged diastolic filling,so more oxygen supply
Nitrates and dihydropiridine calcium channel blockers cause
Reflex tachycardia
NO donors cause
Venodilation, arterial dilation and coronary arterial dilation,so hypotensive and antianginal effect
Glyceril trinitrate,fast and short acting
1-3min start, duration 20-30min, sublingual,first pass effect, antianginal
Side effects of glyceril nitrate
Headache, hypotension,reflex tachycardia
ISMN,Long acting,6-8 hr
Prevention of angina attack, interactions with pde5inhibitors cause life threatening hypotensive reaction
Dihydropiridine drugs are
Vasoselective calcium channel blockers -vasodilation
Dihydropiridine drugs acts on peripheral arteries and
Coronary arteries,cause dilation and antianginal and hypotensive effect
Side effects of dihydropiridine calcium channel blockers
Headache,facial flushing, fatigue, peripheral edema, constipation
Vasospastic anginais same as
Princmetals angina
Clinical use of dihydropiridine drugs
Prevention or prophylaxis of angina attack and prevention of vasospastic angina attack
Non dihydropiridine calcium channel blockers are
Cardiodepressent and are non selective
Clinical use of both calcium rare same
Prevention of angina attack and vasospastic angina attack