Exam 1: Ischemia and CAS Flashcards
What type of angina is considered “Demand Ischemia”
Stable
What are the characteristics of Stable Angina
occurs upon exertion
improves with rest
chronic yet stable coronary obstruction
What are goals for the treatment of chronic/variant angina
dilate coronary arteries ( decrease afterload)
Decrease O2 demand
Decrease preload
What does dilating coronary arteries do?
Decrease afterload “A”
what does dilating veins do?
Decrease preload
How do nitrates work?
Act on GC to increase cGMP to dephosphorylate MLC and cause venous relaxtion
What do nitrates do to cGMP
Increase it
Which drug acts on GC
nitrates
How do CCBs work?
block L-type channels to prevent calcium influx that would otherwise activate calmodulin and cause contraction
Which drug prevents the activation of calmodulin?
CCBs! (C)
How do Beta blockers work?
they prevent the stimulation of the myocardium by epinephrine by preventing the release of calcium from the SR
What is the target of CCBs and why? (veins or arteries)
Arteries! They lack the SR calcium stores that veins have making the CCB effective
What state of the heart are cardiac cells able to be better perfused? (systole or diastole)
Diastole
What does the decreased heart rate during exertion allow beta blockers to do?
prolong diastole
what does ivabradine do?
prolong diastole and improve ventricular filling