Chronic Chest pain therapeutics

Question 1

What do calcium channel blockers do?

Answer 1

Act on cardiac and smooth muscle by blocking L-type calcium channels (voltage gated)

prevent vasoconstriction. so vasodilate and reduce heart rate

Question 2

What are some calcium channel blocker examples

Answer 2

Dihydropyridines: nifedipine, felodipine; act on resistance vessels. (can cause flushing and headache)
Phenylalkamines on cardiac tissue; verapamil

Question 3

Whats an example of a nitrate and what is its mechanism

Answer 3

nicorandil

Nitrate AND K+ATP channel opener, this hyperpolarises cells and inactivates the voltage gated calcium channels
VASODILATOR

can cause headaches

Question 4

What statins are commonly used

Answer 4

simvastatin and atorvastatin

Question 5

How do statins work

Answer 5

inhibit HMG coa reducatase (enzyme that is part of the cholesterol synthesis pathway)

as a result hepatocytes internalise all circulating LDL to make cholesterol by expressing LDL receptors

Question 6

What are statin side effects?

Answer 6

Skeletal muscle aches so myalgias, myositis. May be teratogenic and might alter LFT’s