Antianginal Agents Flashcards
What is angina pectoris?
suffocation of the chest
pain caused by the imbalance between O2 being supplied to the heart muscle and demand for O2 by the heart muscle
What is an atheroma?
plaque in the endothelial lining of arteries of the heart
contains fats, blood cells, lipids, inflammatory agents, and platelets
What leads to narrowing of the lumen of the artery, stiffening of the artery, and loss of distensibility and responsiveness?
atheroma
What is atherosclerosis?
narrowing of the arteries caused by buildup of atheromas, swelling, and accumulation of platelets
What leads to a loss of arterial elasticity and responsiveness to normal stimuli?
atherosclerosis
Describe coronary artery disease (CAD).
characterized by progressive narrowing of the coronary arteries leading to a decreased delivery of O2 to cardiac muscle cells
What is a myocardial infarction, what causes it and what does it cause?
Caused by vessel blockage in the heart
ischemia and then necrosis of the area cut off from the blood supply. This causes cell death and MI
The dead cells are eventually replaced by scar tissue
What are nitrates and what is the outcome of their use?
Drugs used to cause direct relaxation of smooth muscle leading to vasodilation and decreased venous return to the heart with decreased resistance to blood flow
Outcome: rapidly decreased the O2 demand in the heart and can restore the balance between blood delivered and blood needed in the heart muscle of patients with angina
What is a prinzmetal angina?
caused by spasm of the blood vessels, not just by vessel narrowing
occurs @ the same time, each day, often @ night
What is pulse pressure?
the systolic blood pressure minus the diastolic blood pressure
reflects the filling pressure of the coronary arteries
What is a stable angina?
pain due to the imbalance of myocardial O2 supply and demand; the pain is relieved by rest or stoppage of activity
What is an unstable angina?
an episode of myocardial ischemia with pain due to the imbalance of myocardial O2 supply and demand when the person is at rest and/or at unpredictable times
This has an increased risk of MI
What are the s/sx of Acute MI?
excruciating pain nausea severe sympathetic stress rxn diaphoresis anxiety GI problems
Describe the pathophysiology of Acute MI
if a coronary vessel becomes completely occluded and is unable to deliver blood to the cardiac muscle, the area of muscle that depends on that vessel for O2 becomes ischemic and then necrotic. This leads to myocardial cell death.
What is the MOA of antianginal drugs?
Improve blood delivery to the heart muscle by dilating blood vessels; this increases the supply of oxygen to the heart
Improve blood delivery to the heart muscle by decreasing the work of the heart; this decreases the demand for O2 by the heart
