Clinical Pharmacology of Stable Coronary Artery Disease Flashcards
Describe stable angina.
Stable angina is a clinical syndrome characterized by predictable chest pain triggered by exercise or emotional stress, leading to increased myocardial oxygen demand.
Define atypical angina.
Atypical angina is similar to stable angina but presents with symptoms that are not clearly identifiable as ischemic chest pain.
How is stable angina differentiated from ACS?
Stable angina is not usually a medical emergency and does not require immediate medical attention, unlike Acute Coronary Syndrome (ACS).
Do beta blockers help in treating stable angina?
Yes, beta blockers are used to relieve symptoms, reduce workload, improve coronary blood flow, slow/halt the disease process, prevent myocardial infarction, and prevent premature death in stable angina patients.
Describe the mechanism of action of beta blockers.
Beta blockers work by blocking the beta1 and beta 2 receptors, inhibiting the sympathetic system, and reducing heart rate, contractility, and systolic wall tension.
How do calcium channel blockers function in stable angina treatment?
Calcium channel blockers can act as rate-limiting agents or vasodilators, helping to reduce myocardial oxygen demand and improve coronary blood flow in stable angina patients.
Describe the mechanism of action of calcium channel blockers.
They prevent calcium influx into myocytes and smooth muscle arteries/arterioles by blocking L-type Ca channels.
What are the main differences between dihydropyridine and non-dihydropyridine calcium channel blockers?
Dihydropyridines mostly relax smooth muscle, while non-dihydropyridines mostly reduce heart rate.
Define the role of nitrates as vasodilators.
Nitrates release Nitric Oxide, which mediates smooth muscle relaxation, reducing preload and afterload.
How does Nicorandil function as a vasodilator?
It activates ATP sensitive potassium channels, causing potassium influx and inhibiting calcium influx, leading to smooth muscle relaxation.
Do Ivabradine act as a rate-limiting medication? If so, how?
Yes, Ivabradine is a rate-limiting medication that inhibits the ‘funny’ channels located in the SA node.
Describe the mechanism of action of Ranolazine.
Inhibits late sodium current in myocardial cells and inhibits rapid phase of delayed potassium rectifier current, reducing intracellular calcium.
What are the benefits of using Ranolazine?
Reduced O2 demand, potential antiarrhythmic effects, and slowing disease progression.
Define HMG-CoA Reductase inhibitors and provide examples.
They reduce cholesterol production. Examples include Atorvastatin, Simvastatin, and Rosuvastatin.
How does Ezetimibe work in reducing cholesterol levels?
It inhibits cholesterol uptake in the gut, forcing the liver to increase uptake from the bloodstream, thus lowering LDL levels.
