Drugs and Coronary Heart Disease

Question 1

How do nitrates work?

Answer 1

• GTN - fast acting, sublingual tablet or spray. Rapidly metabolised by liver.
• Release nitrogen oxide (NO) which increases cGMP in muscle cells causing them to relax.
• Reduces heart filling/contraction strength.
• Caution with hypertension drugs + viagra

Question 2

What are the side effects of GTN?

Answer 2

• Throbbing headache (cerebral vasodilation)
• Dizziness (low BP)

Question 3

How do statins work?

Answer 3

• HMG-CoA reductase is rate-limiting step in cholesterol synthesis (lipid-lowering)
• Given to those with high cholesterol - Prevents atheroma formation

Question 4

What are the side effects of statins?

Answer 4

• GI upset
• Abnormal liver tests (mild)
• Muscle problems (myopathy)

Question 5

What is an effect of GTN?

Answer 5

• Increased heart rate.

Question 6

Which drug helps to reduce cholesterol in the blood?

Answer 6

• Simvastatin