Antianginal - Overview Flashcards
What is the mechanism by which pharmacologic treatments can reduce angina?
The reduction of myocardial oxygen consumption by decreasing one or more of the determinants of oxygen consumption: end diastolic volume, blood pressure, heart rate, contractility, and/or ejection time
Among the calcium channel blocker, which acts most like nitrates in treating angina? Which acts like a blocker?
Nifedipine; verapamil
What are the effects of nitrates, blockers, and a combination of both on end diastolic volume?
Blockers increase end diastolic volume, nitrates decrease end diastolic volume, and a combination of both either has no effect or decreases end diastolic volume
What are the effects of nitrates, blockers, and a combination of both on blood pressure?
Blockers, nitrates, and a combination of both all decrease blood pressure
What are the effects of nitrates, beta blockers, and a combination of both on contractility?
Blockers decrease contractility, nitrates increase contractility (as a reflex response), and a combination of both has little/no effect on contractility
What are the effects of nitrates, blockers, and a combination of both on heart rate?
Blockers decrease heart rate, nitrates increase heart rate (as a reflex response), and a combination of both decreases heart rate
What are the effects of nitrates, blockers, and a combination of both on ejection time?
Blockers increase ejection time, nitrates decrease ejection time, and a combination of both has little/no effect on ejection time
What are the effects of nitrates, blockers, and a combination of both on myocardial oxygen consumption?
Blockers and nitrates decrease myocardial oxygen consumption, but a combination of both severely decreases myocardial oxygen consumption
Which two beta-blockers are contraindicated in angina and why?
Pindolol and acebutolol because they are partial beta-agonists and can increase myocardial oxygen consumption
