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Master YLL Pharmacology > CVS - Ischemic Heart Disease and Treatment > Flashcards

CVS - Ischemic Heart Disease and Treatment Flashcards

1
Q

What are the types of angina associated with ischemic heart disease?

A

Atherosclerotic, Vasospastic, and Unstable Angina.

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2
Q

What factors determine cardiac oxygen requirement?

A

Preload, heart rate, afterload, and cardiac contractility.

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3
Q

What is the therapeutic aim of vasodilators in angina treatment?

A

To decrease cardiac oxygen demand and increase oxygen supply.

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4
Q

What is the mechanism of action of nitrates in IHD?

A

They cause vasodilation, reducing myocardial oxygen demand.

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5
Q

How are glycerol nitrates used in acute angina treatment?

A

They provide rapid relief from angina by dilating coronary arteries.

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6
Q

What are the pharmacokinetics of isosorbide dinitrate and mononitrate?

A

They are long-acting nitrates, metabolized in the liver, with prolonged effects.

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7
Q

What are common side effects of nitrates?

A

Headache, hypotension, reflex tachycardia, and venous dilation.

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8
Q

How do beta-blockers work in treating IHD?

A

They reduce heart rate and contractility, lowering myocardial oxygen demand.

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9
Q

What are the effects of dihydropyridine calcium channel blockers on blood pressure?

A

They cause vasodilation, leading to a decrease in blood pressure.

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10
Q

What is the mechanism of action of ivabradine in IHD treatment?

A

It reduces heart rate by inhibiting the If channel in the sinoatrial node.

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11
Q

Which drugs are used for treating hypertension in IHD patients?

A

Diuretics, beta-blockers, ACE inhibitors/ARBs, and calcium channel blockers.

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12
Q

How do non-dihydropyridine calcium channel blockers aid in IHD treatment?

A

They decrease heart rate and contractility, reducing oxygen demand.

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13
Q

What is the role of preload in cardiac oxygen requirement?

A

Higher preload increases oxygen demand due to an increased volume of blood.

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14
Q

How does afterload affect cardiac oxygen requirement?

A

Higher afterload increases oxygen demand due to increased vascular resistance.

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15
Q

What are vasorelaxation side effects in nitrate therapy?

A

Vasorelaxation can cause dizziness and orthostatic hypotension.

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16
Q

What is the effect of reflex tachycardia in nitrate therapy?

A

It can counteract the benefits of vasodilation by increasing heart rate.

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17
Q

How do beta-blockers affect exercise-induced angina?

A

They reduce the frequency and severity of exercise-induced angina.

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18
Q

What are the potential side effects of beta-blockers in IHD?

A

Fatigue, bradycardia, bronchospasm, and worsening of peripheral vascular disease.

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19
Q

What is the clinical use of isosorbide mononitrate in IHD?

A

It’s used for long-term prophylactic management of angina.

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20
Q

How do dihydropyridines differ from non-DHP calcium channel blockers?

A

Dihydropyridines primarily cause vasodilation, while non-DHPs also affect the heart rate and force of contraction.

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21
Q

What is a unique feature of ivabradine compared to other antianginal drugs?

A

It specifically targets heart rate without affecting blood pressure or myocardial contractility.

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22
Q

In what conditions are beta-blockers contraindicated in IHD?

A

Asthma, severe bradycardia, and advanced heart block.

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23
Q

How does vasospastic angina differ from atherosclerotic angina?

A

Vasospastic angina is caused by coronary artery spasms, while atherosclerotic angina is due to plaque buildup.

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24
Q

What is the significance of unstable angina in IHD?

A

It indicates a high risk of myocardial infarction and requires immediate medical attention.

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25
Q

Why is meningeal artery vasodilation a concern in nitrate therapy?

A

It can lead to headaches, a common side effect of nitrates.

26
Q

How do calcium channel blockers help in vasospastic angina?

A

They prevent or relieve coronary artery spasms.

27
Q

What are the adverse effects of calcium channel blockers in IHD?

A

Peripheral edema, constipation (with non-DHPs), and dizziness.

28
Q

What is the main disadvantage of short-acting nitrates?

A

They may cause tolerance, reducing their effectiveness over time.

29
Q

Why is monitoring renal function important in IHD patients on diuretics?

A

To prevent renal impairment and electrolyte imbalances.

30
Q

How do ACE inhibitors/ARBs benefit IHD patients with hypertension?

A

They reduce blood pressure and have protective effects on the heart and kidneys.

31
Q

What is the relevance of cardiac depressants in angina therapy?

A

They reduce myocardial oxygen demand by decreasing heart rate and contractility.

32
Q

Why is cardiac pacemaker retardant therapy used in IHD?

A

To slow the heart rate, reducing myocardial oxygen demand and improving oxygen supply.

33
Q

What is the therapeutic effect of nitrates in acute angina?

A

Rapid relief of chest pain by dilating coronary arteries and reducing preload.

34
Q

How do beta-blockers improve survival in IHD patients?

A

By reducing the risk of arrhythmias and myocardial infarction.

35
Q

What is the first-line treatment for chronic stable angina?

A

Beta-blockers, due to their effectiveness in reducing angina frequency and severity.

36
Q

Why is patient education important in nitrate therapy?

A

To ensure proper use, prevent tolerance, and manage side effects.

37
Q

What lifestyle modifications are recommended for IHD patients?

A

Smoking cessation, dietary changes, and regular exercise.

38
Q

How do aldosterone antagonists contribute to IHD treatment?

A

By reducing fluid overload and myocardial fibrosis.

39
Q

Why should IHD patients avoid sudden discontinuation of beta-blockers?

A

To prevent rebound hypertension and worsening angina.

40
Q

How do SGLT2 inhibitors benefit IHD patients with diabetes?

A

They improve glycemic control and reduce cardiovascular risk.

41
Q

Why is monitoring blood pressure essential in IHD patients on vasodilators?

A

To prevent excessive hypotension and syncope.

42
Q

What is the role of diuretics in IHD treatment?

A

To reduce preload and alleviate symptoms of heart failure.

43
Q

How do ARBs differ from ACE inhibitors in their mechanism of action?

A

ARBs block angiotensin II receptors, while ACE inhibitors prevent the formation of angiotensin II.

44
Q

What are the indications for using ivabradine in IHD?

A

To reduce angina frequency and improve exercise tolerance in patients intolerant to beta-blockers.

45
Q

What are the contraindications for calcium channel blocker use in IHD?

A

Severe hypotension, heart block, and heart failure with reduced ejection fraction.

46
Q

What is the primary symptom of ischemic heart disease?

A

Angina pectoris.

47
Q

What is the main goal of treatment in ischemic heart disease?

A

To reduce myocardial oxygen demand.

48
Q

How do ?-blockers help in IHD?

A

They decrease heart rate and contractility.

49
Q

What is the role of calcium channel blockers in IHD?

A

They reduce systemic vascular resistance and myocardial contractility.

50
Q

How do nitrates help in IHD?

A

By producing venous dilation, decreasing preload, and thus oxygen demand.

51
Q

What is the effect of lipid-lowering drugs in IHD patients?

A

They reduce the risk of heart attacks.

52
Q

How is unstable angina treated in IHD?

A

With nitroglycerin, antiplatelet, and anticoagulant drugs.

53
Q

What is the treatment for acute myocardial infarction in IHD?

A

Thrombolytic agents, and direct reversible P2Y12 receptor antagonists.

54
Q

How do organic nitrates work?

A

They are sources of nitric oxide (NO), leading to vasodilation.

55
Q

What is the administration route of nitroglycerin for rapid onset?

A

Sublingually, to avoid first-pass metabolism.

56
Q

What are common side effects of nitroglycerin?

A

Headache, orthostatic hypotension, and tachycardia.

57
Q

How is heart failure related to ischemic heart disease?

A

It is often a consequence of IHD, among other causes.

58
Q

What is the common cause of heart failure?

A

Ischemic heart disease, arterial hypertension, valvular diseases, and others.

59
Q

How do antiplatelet drugs help in IHD?

A

By preventing thrombus formation in the coronary arteries.

60
Q

What are the benefits of ?-blockers in exertional angina and post-MI?

A

They are effective in reducing angina and improving survival post-myocardial infarction.

Master YLL Pharmacology (36 decks)

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