CVS - ischemic heart disease

Question 1

Drugs for angina pectoris

Answer 1

1. vasodilators: NO, Ca2+ channel blockers
2. cardiac depressants: beta blockers, Ca2+ channel blockers
3. anti-platelets
4. lipid-lowering drugs

Question 2

Nitrate drug

Answer 2

nitroglycerin: so- educateurce of NO

Question 3

Nitrates MOA

Answer 3

cause vasorelaxation - decrease preload and afterload -> decrease O2 consumption

Question 4

Nitrates ADR

Answer 4

• baroreflex compensation: detects the sudden decrease in BP by vasodilation effect -> tachycardia instead
• meningeal artery vasodilation, causing headache
  (use tgt with beta/Ca2+ channel blockers to minimise ADR)

Question 5

Beta blockers MOA

Answer 5

b1 in heart: increase HR and contractility
b2 in SM: cause vasodilation

beta blcokers effect:

• prolong AV conduction
• decrease HR and contractility

Question 6

Beta blockers drugs

Answer 6

(-olol)
non-selective: 
- propanolol
- timolol
- nadolol
- carteolol
selective b1 blockers:
- atenolol
- metoprolol
- acebutolol
- esmolol

Question 7

Beta blockers ADR

Answer 7

• bradycardia
• CNS effects: sedation
• asthma (bronchoconstrictor)
• withdrawal symptoms
  not to be used in diabetic patients

Question 8

Ca2+ channel blockers drugs

Answer 8

• verapimil
• diltiazem
• nifedipine

Question 9

Nifedipine MOA

Answer 9

decrease contractility -> decrease O2 requirement = anti-angina
decrease vascular smooth muscle tone -> decrease BP
best as a vasodilator

Question 10

Veramipil MOA

Answer 10

decrease SV/AV nodal conduction - decrease supraventriculae tachycardia - anti-arrhythmia
best as a cardiac depressant