Antianginal Drugs Flashcards
3 types of Angina
- Classic (stable): occurs w/ predictable stress or exertion
- Unstable (preinfarction): occurs frequently with progressive severity unrelated to activity; unpredictable regarding stress / exertion and intensity
- Variant (vasospastic): occurs during rest
Type of angina that occurs w/ predictable stress or exertion
CLASSIC
Type of angina that occurs frequently with progressive severity unrelated to activity; unpredictable regarding stress / exertion and intensity
UNSTABLE (Pre-infarction)
Type of angina that occurs during rest
VARIANT (VASOSPASTIC)
3 agents for the treatment of Angina
- Organic nitrates
- Beta-blockers
- Calcium -channel blockers
Explain the mechanisms of each antianginal drugs
NITRATES:
- can cause vasodilation of the veins and coronary artery
BETA-BLOCKERS:
- decrease the heart rate
CALCIUM CHANNEL BLOCKER:
- decrease force of contraction leading to a decreased myocardial workload and demand
How do you tell that anti anginal drugs are effective?
IF CHEST PAIN IS RELIEVED
These agents are simple nitric and nitrous acid esters of alcohols
ORGANIC NITRATES
Example of Nitrates
- Nitroglycerin
- Isosorbide Dinitrate / Mononitrate
- Amyl nitrate
A moderately volatile nitrate
NITROGLYCERIN
An extremely volatile nitrate
AMYL NITRATE
This relaxes the smooth muscles in the vascular system by its conversion to nitric oxide (a chemical mediator in the body that relaxes smooth muscle)
NITROGLYCERIN
Administration route of Nitroglycerin
SUBLINGUAL
Most common effect of nitroglycerin
HEADACHE
How do you manage tolerance of medicine?
ABSTINENCE
Giving nitroglycerin is limited to the number of __
3
This is a sympathomimetic drug often used to treat hypotension in shock states that are not caused by hypovolemia
This drug is an immediate precursor of norepinephrine
This also stimulates receptors to cause cardiac stimulation and renal vasodilation
DOPAMINE
Dose range of Dopamie
1-20 mg/kg/min
Explain mechanism of dopamine in different doses
- Low dose (1-2 mg)
- Moderate dose (2-10)
- Higher doses ( more than 10)
LOW : Dilates renal and mesenteric blood vessels
MODERATE: enhance cardiac output by increasing heart rate and elevates blood pressure thru peripheral vasoconstriction
HIGHER: vasoconstriction of all vessels
It will inactivate dopamine
SODIUM BICARBONATE
How will you know that dopamine is effective?
- Increased urine output
- Increased BP
These are conduction dysfunctions caused by abnormalities in impulse generation or impaired transmission of the impulses
ARRHYTHMIAS
Deviations from the normal rate or pattern of heartbeat
ARRHYTHMIAS
These agents are given to modify impulse generation and conduction. It restores the cardiac rhythm to normal
ANTI-ARRHYTHMIC AGENTS
Cardiac action potential
1: K+ efflux (repolarization)
2: K+ efflux & Ca+ influx
3: K+ efflux
4: Resting membrane potential; steady K+
Classes of anti-arrhythmic agents:
- Class 1: fast sodium
- Class 2: beta-blockers
- Class 3: potassium channel blockers
- Class 4: calcium channel blockers
This class of anti-arrhythmic are fast fast SODIUM channel blockers that affects depolarization phase
CLASS 1
This class of anti-arrhythmic are BETA blockers that affect depolarization
CLASS II
This anti-arrhythmic class are a POTASSIUM channel blocker that diminish outward potassium current during repolarization of cardiac cells
CLASS III
This anti-arrhythmic agents are CALCIUM channel blockers that decrease the calcium influx
CLASS IV
