Drugs for Ischemic Heart Disease

Question 1

Main goal

Answer 1

Decrease myocardial oxygen demand

Question 2

Nitrates

Answer 2

Nitroglycerin & isosorbide dinitrate

Question 3

Describe MOA of nitrates

Answer 3

1. Exogenous supply of NO
2. Activation of guanylyl cyclase
3. Increase in cGMP
4. Decrease in Ca2+
5. Venodilation
6. Venous polling
7. Decrease in venous return
8. Decrease in preload
9. Decrease in ventricular pressure
10. Decrease in cardiac work
11. Decrease in myocardial oxygen demand
12. Angina relieved

Question 4

State an adverse side effect of taking vasodilators

Answer 4

Coronary steal syndrome

Question 5

Nondihydropyridine calcium channel blockers

Answer 5

1. Verapamil

2. Diltiazem

Question 6

Dihydropyridine calcium channel blockers

Answer 6

1. AMLOdipine

2. NIFEdipine

Question 7

Describe MOA of nondihydropyridine calcium channel blockers - verapamil & diltiazem

Answer 7

1. Block L-type Ca2+ channels
2. Decreased myocardial contractility
3. Decreased SA node discharge rate
4. Decreased AV node conduction
5. 3 & 4 decrease heart rate
6. Decreased myocardial oxygen demand
7. Angina relieved

Question 8

If channel antagonist

Answer 8

Ivabradine

Question 9

Refer to slides

Answer 9

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