Antianginal Agents Flashcards
Nitrates
Nitroglycerin
Treatment of…
- Acute Angina
- Prophylaxis of angina
- IV treatment of angina unresponsive to beta-blockers or organic nitrates.
- To produce controlled hypotension during surgery
- Perioperative HTN
- HF associated with MI
Nitroglycerin adverse effects
Chest pain
Sweating
Tachycardia
hypotn
Dont use if you have head trauma or cerbral hemmorhage
DONT combine with drugs used to treat erectile dysfunction
Nitroglycerin Actions
Relaxes vascular smooth muscle with a resultant decrease in venous return and decrease in arterial blood pressure, reducing the left ventricular workload and decreasing myocardial oxygen consumption.
Beta-Blockers
Metoprolol
Treatment of…
- Stable angina pectoris
- Prevention of reinfarction in MI pt’s
- stable, symptomatic HF
- HTN
Metoprolol Actions:
Competitively blocks beta receptors in the heart and kidneys, decreasing the influence of the sympathetic nervous system on these tissues and the excitability of the heart; decreases cardiac output which results in a lowered blood pressure and decreased cardiac workload.
Metoprolol adverse effects
Decreased exercise tolerance
Impotence
HF
Gastric pain
Calcium Channel Blockers
Diltiazem
Indications: Treatment of…
- Prinzmetal angina
- Effort-associated angina
- Chronic stable angina
- Essential HTN
- Paroxysmal SVT
Diltiazem Actions
Inhibits the movement of Ca across the membranes of myocardial and arterial muscle cells, altering action potential and blocking muscle cell contraction, which depresses myocardial contractility.
Dilates arteries, causing fall in BP and decrease in venous return; workload of heart; oxygen consumption; relieves vasospasm of coronary artery, increasing blood flow to the muscle cells (prinzmetal angina)
Diltiazem adverse effects
AV block Peripheral edema Asthenia Rash Bradycardia
