Antianginals Flashcards
Stable Angina
- short lived, stops with removal of stress
- reduced coronary perfusion caused by atherosclerosis
Unstable Angina
- present with no extra effort
- not relieved by nitroglycerin
Prinzmetal/Variant Angina
- caused by spasm of coronary arteries
- responds to vasodilators (nitroglycerin/Ca+ channel blockers)
Progression of drugs used
1) sublingual nitrate
2) B-blockers
3) Ca+ channel blockers or long-acting nitrates
(4) Ranolozine/sodium channel blocker)
Organic Nitrate action
-vascular smooth muscle relaxation
(↑cGMP -> dephosphorylate myosin -> relaxation)
-reduces myocardial oxygen demand
Organic Nitrate drugs
- sublingual nitroglycerin (short acting)
- isosorbide dinitrate (longer acting)
- isosorbide mononitrate (longest acting)
B-Adrenergic Blocker action
- ↓HR, ↓contractility, ↓CO, ↓BP
- increases myocardial blood supply
- decreases myocardial demand
B-Blocker drugs
- atenolol / tenormin
- metaprolol / lopressor
- acebutolol / sectral
Atenolol / tenormin
- cardioselective B1 blocker
- 50-100 mg/day
- 24 hour duration
- 6 hour half-life
metaprolol / lopressor
- cardioselective B1 blocker
- MI prevention and treatment
- management of heart failure
acebutolol / sectral
- cardioselective B1 blocker
- 200-400 mg/day
- 3-4 hour half-life
Calcium Channel Blocker action
-improves diastolic filling
(reduces increased Ca+ in ischemic myocardium)
-reduced cardiac workload/O2 comsumption
(arteriolar vasodilation -> reduced PVR)
Calcium Channel Blocker drugs
- amlodipine / norvasc
- diltiazem / cardizem
- verapimil / calan
amlodipine / norvasc
- calcium channel blocker
- long acting
- treats HTN and angina
diltiazem / cardizem
- calcium channel blocker
- coronary and peripheral vasodilator
