Cardiovascular and AntiAnginals Flashcards
Amyl Nitrate, Isosorbide Dintrate, Isosorbide mononitrate and Nitrogylcerin
Nitrates
Indication: Angina
MOA 1: Coronary artery dilation leads to decreased coronary bed resistance leads to increased BF Increased O2 supply
MOA2: Reduce TPR, Decreased BP, Decreased after load, decrease work load Decrease O2 Consumptions
MOA3: reduce venous return, decrease LV Vol. decreased preload, decrease work load and Decrease 02 consumption
Could lead to reflex tachycardia, increase in contractility and decreased diastolic perfusion due to tachycardia
Nitroglycerin
Sublingual or patch
Adverse: HA, and could lead to tolerance… short acting
Sublingual: 2-25 min
Oral: 35min - 4/8 hours
Transdermal: 30min-8/14 hours
Isosorbide dinitrate
Mononitrate can avoid first pass metabolism and is metabolite very active
Sublingual: 5min - 1hr
Oral slow: 30min - 8hrs
Isosorbide mono
Oral extended: 30min - 12 hrs
Atenolol, Metoprolol, Nadolol, and propranolol
B-Blocker
Indication: Angina used for therir Vasodilation effects
MOA:
Atenolol, Metoprolol, Nadolol, and propranolol
B-Blocker Neg inotropic and chronotropic
Indication: Angina used for therir Vasodilation effects
MOA:decreased the workload
Effect: leads to reduced O2 consumption but reduces hr and contract
Propranolol is nonselective do not use w/ Asthma or COPD.
Adverse may exacerbate HF due to reflux tachycardia
Nifedipine, felodipine, amlodipine, nitrendipine, nicardipine, nimodipine
Dihydropyridines
Indication:
MOA: Blocks Ca2+ channels so in cardiac muscle decreased in Ca+ SMC leads to relaxation.
nimodipine: cerebral blood
NIcardinipine: Coronary BV
Improves o2 delivery to ischemic myocardium and reduces o2 consumption
Verapamil and diltiazem
Ca2+ channel blocker
Less vasodilation than DHP
But greater neg chronotropic, dromotropic and inotropic effects
Indication: Angina
MOA: decreased BP(after-load) and may cause reflux tachycardia
Adverse: dont use in pts w/ chf.. do not want to vasodilation
