Coronary disease Flashcards
Names of Vasodilators - Nitrates?
Glycerol Nitrates
Isosorbide Mononitrate (ISMN)
MOA of Glycerol Nitrate?
More Nitric Oxide - guanylyl Cyclase - cGMP - Myosin-LC - Vasorelaxation
Smooth muscle relaxation leads to peripheral venodilation, lowering Cardiac Output through lower preload.
Arteriolar dilation lowers peripheral resistence and blood pressure, lowering cardiac muscle oxygen consumption
Use of Glycerol Nitrate?
Acute treatment of Angina pectoris
MOA of ISMN
At low Plasma conc - venous dilation - peripheral pooling - lower LV Preload
At high plasma conc - dilate arteries also - lower Cardiac afterload
Dilate coronary arteries by lowering end diastolic pressure and volume - lower intramural pressure - improve subendocardial blood flow
MOA of Beta blockers in coronary disease?
Block Beta-1 receptors in cardiac myocytes, lowering contractility and rate
Name of Calcium channel blockers?
Verapamil
Diltiazem
Nifedipine
Amlodipine
MOA of Verapamil and Diltiazem?
Lower SA and AV node, lowering supraventricular re-entry tachycardia
Use of Verapamil and Diltiazem?
Arrhythmia
MOA of Nifedipine and Amlodipine?
- Lower Myocardial contractility lowers CO and BP falls. Less Oxygen is needed and helps Angina.
- Lower vascular smooth muscle tone, helping Anti-angina
Uses of Nifedipine and Amlodipine?
Anti angina
Anti Hypertension
ADR of Verapamil, Diltiazem, Nifedipine and Amlodipine?
Cardiac Depression:
Bradycardia
AV Blocker
Heart Failure
DHP Calcium channel blocker name?
Amlodipine
DHP Calcium channel blocker Uses?
Hypertension
Stable Angina
Myocardial Infarction and stroke prevention
ADR of DHP Ca channel blocker?
Hypotension
Heart Failure
AMI
ADR of Nitrates?
Reflex tachycardia
Hypotension
Headache (meningeal artery vasodilation)
