Drug used in Ischemic heart Disease Flashcards
Cardiovascular disease
CVDs are the number ____ cause of death globally.
1
more people die annually from CVDs than from any other cause.
T/F
T
An estimated 17.5 million people died from CVDs in 2012, representing 31% of all global deaths.
By 2030, 23.6 million people will probably die of CVD.
Most of the death will occur in ____________-income countries.
low- and middle
In Nigeria, Prevalence of HTN is about ___%.
35
HTN is a major risk factor for CVD.
T/F
T
ANGINA PECTORIS
Angina pectoris refers to a strangling or pressure like pain caused by ________
cardiac ischaemia.
Angina
It’s a _____ syndrome due to induction of an adverse oxygen supply / demand situation in portion of myocardium.
pain
Drugs used to treat angina exploit two main strategies:
reduction of _______ and
increase of the ___________
oxygen demand
oxygen delivery to myocardium.
Three types of anginal attack: ______ angina, ______ angina and ______ angina.
stable; unstable; variant
Drugs Used in Angina
______ are the 1st-line drugs , leading to ___________, especially in the ______ by acting on vascular smooth muscle that involves the formation of _____ and [______]cyto.
Nitrates
peripheral vasodilation; veins
NO; cGMP
Nitrates
Short-acting nitrates:
_____________(GTN)
Glycerol trinitrate
Nitrates
Short-acting nitrates:
Glycerol trinitrate (GTN) (sl, _____, or ______) acts for ~ ______
-More useful in _________ than in ___________
tablet; spray
30 min.
preventing attacks; stopping them once they have begun.
Nitrates
Short-acting nitrates:
Glycerol trinitrate (GTN)
-Patches (transdermal) have (shorter or longer?) duration of action (~____).
Longer
24 hr
Nitrates
Long-acting nitrates:
are (more or less?) stable and effective for ________
More
several hr.
Nitrates
Long-acting nitrates:
___________ is widely used, but _____________
Isosorbide dinitrate; metabolized rapidly by liver.
Nitrates
Long-acting nitrates:
Isosorbide dinitrate:
____________ (active metabolite) of dinitrate avoids the ________ and unpredictable ________ of the dinitrate.
Isosorbide mononitrate
variable absorption
1st pass metabolism
Nitrates- Adverse effects:
___________ leading to headaches, hypotension and fainting, and in severe cases, reflex tachycardia.
- Can be counteracted with ______
- Prolonged high doses can lead to __________.
Aterial dilation
β-blockers.
methemaglobinemia
Nitrates- Adverse effects:
Mechamism of action: Starts with _____________
formation of nitrite ions
Nitrates
Tolerance to nitrates rarely occurs
Tolerance to nitrates is poorly understood.
F (Tolerance to nitrates occurs regularly),
T(Tolerance to nitrates is poorly understood)
Nitrates
In Tolerance to nitrates
perhaps depletion of _________ group donors may be involved, because
tolerance to nitrates in vitro can sometimes be reversed by ____________. -
sulphydral
N-acetylcysteine
Nitrates
__________ formed from NO inhibits ______ formation from GTP.
Peroxynitrite
All β-blockers must be avoided in asthmatics
T/F
With reason
T
as they may precipitate bronchospasms.
Beta blockers are used as angina prophylaxis
T/F
T
