Ch 51: Drugs for Angina Pectoris

Question 1

How much does coronary blood flow increase during exertion?

Answer 1

four to five-fold

p. 581

Question 2

In patients with severe renal impairment, ranolazine can…

Answer 2

…raise blood pressure by about 15 mm Hg.

p. 588

Question 3

When use of ranolazine plus a CCB is indicated, which drug is the only one that should be used?

Answer 3

amlodipine

p. 588

Question 4

In patients with established CAD, taking simvastatin can…

Answer 4

…decrease the risk of mortality by 35%.

p. 589

Question 5

Dihydropyridine-type CCB’s lack ________________ _______, and so are safer than beta blockers for patients with bradycardia, AV block, or heart failure.

Answer 5

cardiosuppressant actions

p. 590

Question 6

In combination therapy to treat stable angina, drugs are used to decrease oxygen demand via multiple mechanisms.
Beta blockers reduce _____ ____ and _____________, CCB’s reduce _________ (by ________ __________), and nitrates reduce _______ (by ________ _____).

Answer 6

heart rate; contractility
afterload; dilating arterioles
preload; dilating veins

(p. 590)

Question 7

In hypertensive patients with additional risk factors, the target blood pressure is…

Answer 7

…130/80 mm Hg or less.

p. 591

Question 8

Drugs relieve pain of variant angina by…

Answer 8

…relaxing coronary vasospasm. This increases cardiac oxygen supply.

(p. 591)

Question 9

To cause vasodilation, nitroglycerin must first be converted to ______ _____, its active form. This reaction requires a __________ source.

Answer 9

nitric oxide; sulfhydryl

p. 591

Question 10

Nitroglycerin relieves pain of stable angina by ________ _____, which _________ ______ ______, which decreases _______, which decreases ______ ______.

Answer 10

dilating veins; decreases venous return; preload; oxygen demand

(p. 591)

Question 11

What are the 3 characteristic side effects of nitroglycerin?

Answer 11

headache, orthostatic hypotension, and reflex tachycardia

p. 591

Question 12

Beta blockers and ranolazine are not used for…

Answer 12

…variant angina.

p. 592

Question 13

_________ and _________ will intensify cardiosuppression caused by a beta blocker, whereas a dihydropyridine will not.

Answer 13

Verapamil and diltiazem

p. 592

Question 14

Which medication combination is good for treating variant angina? Name an example.

Answer 14

CCB’s and organic nitrates (Ex: Diltiazem and isosorbide)

p. 583