Duan: Anti-Anginal Drugs

Question 1

What is angina pectoris?

Answer 1

acute coronary syndrome with episodic chest pain that is a result of transient coronary ischemia; this leads to inadequate supply of O2 to the working heart muscle

Question 2

Major problem in angina pectoris?

Answer 2

blood supply to the heart is limited as a result of disruption of coronary blood flow or increased demand for oxygen, or both!

Question 3

Anti-anginal drugs are of specific benefit in the treatment of angina pectoris to relieve the (blank)

Answer 3

pain

Question 4

This type of angina is the forerunner to a MI if the frequency and severity increases

Answer 4

unstable angina

Question 5

To treat angina, some drugs increase O2 supply, while others decrease O2 demand. Which drugs increase O2 supply?

Answer 5

nitrates
calcium channel blockers
beta-blockers
statins
aspirin

Question 6

Which drugs can decrease the heart rate and contractile force of the heart to decrease O2 demand?

Answer 6

calcium channel blockers

beta-blockers

Question 7

Which drugs can decrease the preload and afterload of the heart to decrease O2 demand?

Answer 7

nitrates

Question 8

How do nitrates work?

Answer 8

improve blood flow by relaxing and dilating veins and arteries, including the coronary arteries, by increasing NO in smooth muscle cells of blood vessels - this allows more blood to flow through which increases O2 supply and relieves angina

Question 9

How do you administer nitrates? How long does it take before they begin working?

Answer 9

sublingual tablet; rapid onset of action in 30 seconds (1-3 min), lasts for 30 to 60 minutes

Question 10

This nitrate dilates resistance vessels

Answer 10

amyl nitrate

Question 11

This nitrate is long acting

Answer 11

isosorbide dinitrate

Question 12

This nitrate is an explosive compound chemically

Answer 12

erythrityl tetranitrate

Question 13

structurally very similar tonitroglycerin, one of the most powerfulhigh explosives

Answer 13

pentaerythritol tetranitrate

Question 14

How do beta-blockers help relieve angina?

Answer 14

they are used as prophylactic treatment, particularly in patients whose attacks are frequent and unpredictable; decrease heart rate and contractile force, which decreased O2 demand

Question 15

How do calcium channel blockers work to relieve angina?

Answer 15

extremely potent coronary vasodilators –> increase coronary and regional myocardial blood flow –> increases O2 supply

**used in the treatment of variant angina

Question 16

Which drugs are most beneficial in the treatment of MI?

Answer 16

beta-adrenergic antagonists
aspirin
fibrinolytic drugs

Question 17

Which drugs are most beneficial in the treatment of variant angina?

Answer 17

Ca++ channel blockers

Question 18

Which drugs are most beneficial in the treatment of unstable angina?

Answer 18

aspirin

Question 19

In addition, what else can be used to treat angina?

Answer 19

other meds like ACE inhibitors and antiplatelets or blood thinners

lifestyle changes to prevent episodic angina

medical procedures to treat the underlying heart disease