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Pharm Block 2 > Antianginal Drugs > Flashcards

Antianginal Drugs Flashcards

1
Q

What is angina?

A

crushing, strangling chest pain caused by accumulation of metabolic waste products in muscle. Reduced blood flow and oxygen delivery

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2
Q

What drugs increase coronary blood flow?

A

nitrates and calcium channel blockers

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3
Q

What drugs decrease HR?

A

Beta blockers and some calcium channel blockers

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4
Q

Which drugs decrease preload?

A

nitrates

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5
Q

Which drugs reduce afterload?

A

calcium channel blockers

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6
Q

Which type of angina is not exercise induced?

A

Variant Angina

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7
Q

What types of angina occur at rest?

A

Variant and unstable angina

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8
Q

Which types of angina have a ST segment depression?

A

Stable and some unstable

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9
Q

Which types of angina have a raised ST segment

A

variant angina

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10
Q

What causes stable vs. unstable vs. variant angina?

A

Stable is caused by atherosclerotic lesion
Unstable is a mixture of a lesion and vasospasm
Variant is spasm of coronary artery

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11
Q

What do the nitrates do and what is their mechanism of action?

A

act on endothelial cells to release NO, causing vasodilation and reducing venous return to the heart, decreasing preload, and vasodilation of arteries, reducing afterload

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12
Q

What are the nitrate drugs?

A

Nitroglycerin, isosorbide dinitrate and mononitrate, amyl nitrite

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13
Q

What is a side effect of amyl nitrite

A

Amyl nitrite can cause methemoglobinemia, used for patients with cyanide poisoning

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14
Q

What conditions are nitrates used for?

A

Any form of angina - stable, unstable, variant

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15
Q

What are side effects of nitrates?

A

orthostatic hypotension, reflex tachycardia, throbbing headache, methemoglobinemia. Sublingual drugs can cause burning sensation; oral results in few SE.

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16
Q

What is nitrate tolerance?

A

Tolerance occurs due to depletion of intracellular sulfhydryls and densensitization of soluble guanylyl cyclase.
It’s recommended to avoid nitrates at night when oxygen needs are the lowest.

17
Q

Which Beta blockers are used for Angina?

A

Atenolol and Metapropolol - selective B1 blockers

Nadolol and Propanolol - non-selective beta blockers

18
Q

How do Beta Blockers treat Angina?

A

Prophylactic Tx of stable angina, can be combined with nitrates to reduce HR
Reduce HR, CO, and conduction velocity
Decrease renin release
Decrease sympathetic outflow to periphery

19
Q

What are side effects of Beta Blockers

A

can precipitate heart failure, hypotension, increased airway resistance (non-selective), depression, insomnia, NVD, ED.

20
Q

Contraindications for Beta Blockers

A

Patients with asthma
diabetics, B blockers masks hypoglycemic shock
Patients with CHF
If patients don’t respond to Beta blockers, may have variant angina

21
Q

What are the Calcium channel blockers that cause bradycardia?

A

Verapamil, Diltiazem, Bepridil

22
Q

Which calcium channel blockers cause tachycardia

A

Dihydropyridines

23
Q

What types of angina can calcium channel blockers be used for?

A

All 3: stable, unstable, variant. Reduces vasospasm, afterload and preload

24
Q

What are side effects of Verapamil, Diltiazem, and Bepridil

A

Bradycardia, Hypotension, CHF, Skin rash, Constipation. Can be combined with nitrates

25
Q

What are the side effects of Dihydropyridines (the DIPINES)

A

Tachycardia, hypotension, dizziness, skin rash, peripheral edema. CANNOT be combined with nitrates due to tachycardia x2

26
Q

How does aspirin treat angina?

A

antiplatlet function, prevents blood clotting with turbulent flow. Lose dose should be used on a daily basis

27
Q

How does dipyridamole treat angina?

A

Blocks adenosine reuptake in coronary arteries, acting as a vasodilator. Used in Unstable angina only!

28
Q

What does Ranolazine do?

A

Inhibits FA oxidation since it uses a lot of O2. Use carbohydrates for energy instead which require less oxygen. Overall, reduce O2 consumption in heart.

29
Q

How does Ivabradine treat angina?

A

Blocks sodium channel in SA node, use for both arrhythmias and angina

30
Q

What is combination therapy treatment for angina?

A

Aggrenox: aspirin/extended release dipyridamile

Pharm Block 2 (5 decks)

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