Drugs for coronary heart disease Flashcards
what is glycerol trinitrate (GNT) used for?
Angina
what formulations does GNT take?
sublingual tablet, nasal spray, transdermal patech
what are the side effects of GNT?
headache
dizziness
tachycardia
developing tolerance
what drugs would be used to treat myocardial infarction?
painkillers
anti-arrhythmias
clot busting drugs
what is the mechanism of action of GTN?
produces nitric oxide which increase cGMP (in muscle cells) relaxes muscle (dilates vessels)
what does GTN dilate, arteries or veins?
both
what effect does GTN have on systemic arteries?
reduces resistance
less work for heart
what effect does GTN have on narrow coronary arteries?
doesn’t dilate arteries in heart
what effect does GTN have on large veins?
more blood in venous system so less blood back to heart
heart fills less- less O2 demand for heart
what effect does GTN have on cerebral arteries?
increased cerebral blood flow - throbbing headache
what cautions are there when using GTN?
not with other BP lowering drugs
other drugs acting on nitric oxide pathway (eg. Viagra)
what are the roles of low density lipoproteins and high density lipoproteins?
low - deposits cholesterol in tissues
high returns cholesterol to liver to be processed
what are statins and what do they do?
HMG- CoA reductase inhibitor
lower cholesterol
what is the mechanism of action of statins?
HMG - CoA reductase is a rate limiting step in cholesterol synthesis
dose dependant reduction in total cholesterol and LDL cholesterol (via upregulation of LDL receptors)
what are the side effects of statins?
relatively few
GI upset
abnormal liver test
muscle problems (myopathy - rare but serious)
