Antianginals Flashcards
1
Q
3 forms of Angina
A
- chronic stable angina (treated with nitrates, beta blockers, CCbs, and Ranolazine)
- variant angina (prinzmetals/vasospastic) (treates with CCbs and Nitrates)
- unstable angina (anti ischemics, antiplatelets, and anticoagulants)
- angina is due to lack of oxygen to the heart
2
Q
types of treatment
A
- nondrug therapy includes avoiding factors that precipitate angina and decreasing risk factors
- therapeutic agents include organic nitrates, beta blockers, calcium channel blockers, and ranolazine
3
Q
Anti-ischemics
A
- nitroglycerin
- beta blockers
- Supplemental oxygen
- Morphine
- ACE inhibitors
4
Q
Antiplatelets
A
- Asprin (plavix, ReoPro, integrilin)
5
Q
Anticoagulants
A
- Subcutaneous LMW heparin (lovenox)
- direct thrombin inhibitors (angiomax)
- factor Xs inhibitors arixtra
- IV unfractioned heparin
6
Q
Nitrates
A
- mainstay of antianginal drug Tx
- nitroglycerin is prototype nitrate, has LARGE PO FIRST PASS EFFECT
7
Q
Nitroglycerin
A
- used to treat stable and variant angina, hypertension, etc
- potent vasodilator
- acts directly on vascular smooth muscle
- adverse includes headache, orthostatic hypotension, tachycardia
- interacts negatively with hypotensive drugs, and positively with beta blockers, Verapamil (CCb), and Diltiazem
- TOLERANCE CAN DEVELOP RAPIDLY
8
Q
Beta blockers
A
- includes drugs like propranolol and metoprolol
- adverse effects include things that occur when heart function is decreased like bradycardia
9
Q
Calcium Channel Blockers (CCb)
A
- drugs like VERAPAMIL, Dilatiazem, and nifedipine
- block calcium channels in vascular smooth muscle, preventing contraction of said muscle
- adverse effects are similar to those of beta blockers, and because of this they interact negatively with them
10
Q
Ranolazine
A
- brand new antianginal agent
- benefits are modest and greater in men than in women
- CAN PROLONG THE QT INTERVAL; MULTIPLE DRUG INTERACTIONS
- not first line therapy, used in combo with other antianginals
