IHD meds

Question 1

what drugs are used for ischaemic heart disease?

Answer 1

1. Nitrates
2. Beta blockers
3. Calcium channel blockers

Question 2

MOA of nitrates

Answer 2

Nitrates release NO -> activates guanylyl cyclase -> converts GTP to cGMP -> Myosin-LC to be inactivated to the relaxed form

Question 3

effects of nitrates

Answer 3

vasorelaxation:
1. venodilation -> increase capacity of blood in the vessels -> increase pooling of blood -> lesser blood entering RA -> decrease preload -> decrease O2 demand
2. arteriolar dilation -> decrease peripheral resistance -> decrease after load -> decrease O2 demand
+ dilatory effects of coronary arteries during diastole

Question 4

types of nitrates

Answer 4

1. nitroglycerin
2. isosorbide mononitrate

Question 5

what are the types of administration for nitroglycerin?

Answer 5

1. sublingual
2. transdermal

Question 6

for sublingual administration: _______ onset of action, _______ duration of action

Answer 6

faster
shorter

Question 7

for transdermal administration: ________ onset of action, _______ duration of action

Answer 7

slower
longer

Question 8

what is sublingual administration of nitroglycerin used for?

Answer 8

acute treatment of angina

Question 9

what is transdermal administration of nitroglycerin used for?

Answer 9

prophylaxis

Question 10

how is isosorbide mononitrate administered?

Answer 10

orally

Question 11

what is isosorbide mononitrate used for?

Answer 11

prophylaxis

Question 12

using isosorbide mononitrate, _____ plasma conc for venodilation effects while _____ conc for arteriolar dilation effects

Answer 12

lower plasma conc for venodilation;
higher plasma conc for arteriolar dilation effects

Question 13

adverse reactions of nitrates (check)

Answer 13

TOO much vasorelaxation:
1. baro reflex -> reflex tachycardia
2. dilation of meningeal artery -> headache
3. forgot