CV & Renal: Anti-Anginal Flashcards
Transient Ischemia due to imbalance between O2 Supply & O2 Demand leads to…
angina
Classic or variant angina?
Etiology: obstruction of coronary vessels w/ exercise
Tx: Drugs, or CABG or Angioplasty
Classic “Angina of Effort”
Classic or variant angina?
Etiology: Spasm/Constriction in atherosclerotic vessels
Tx: Nitrates or CCBs
Variant
Ischemia can be relieved by increasing O2 supply or decreasing demand… what is the major mechanism used pharmacologically?
decrease demand
Which drugs have the following mechanism?
↑ Endothelial NO →
↑ Guanylyl Cyclase →
↑ cGMP →
↑ Dephosphorylation of Myosin LC →
Relaxation
Nitroglycerine and isosorbide dinitrate
Do nitrates and nitrites cause even vasodilation?
no, large veins dilated more than arterioles
Nitrates/nitrites are DOC for which kinds of acute angina?
classic and variant
Which drug class has the following adverse effects?
Acute Toxicity → Profound Vasodilation → Throbbing headache, hypotension, tachy
Tolerance w/ repeat exposure
Nitrates/Nitrites
Describe the kinetics of PO nitrates/nitrites…
high first pass
CCBs relax calcium dependent smooth muscle by binding L-type calcium channels, making them good for treating acute or chronic angina?
chronic
Which CCB can be formulated as slow release for tx of angina?
nifedipine
What adverse effects can nifedipine and dihydropyridines have?
Baroreflex mediated ↑ MI development
What adverse effects can Verapamil & Diltiazem have?
cardiac depression leading to AV Block, HF, Cardiac Arrest
This drug class exerts the following effects on these tissues:
Heart: ↓ CO
Kidneys: ↓ Renin
CNS: ↓ SNS tone
Beta blockers
Do beta blockers directly cause vasodilation?
no