Ischemia Flashcards
Nitroglycerin
dosage forms: IV, SL, TL spray, tablet, ointment, transdermal
ISDN
nitrate
lower potency
better activity than GTN when given orally
doage form: SL, tablet
it is metabolized to ISMN
use: angina; dose once a day
HF (with hydralazine); Dose: 3 -4 x day
CYP 450 metabolized to NO
similar ADR, tolerance, and DDI as GTN
ISMN
nitrate
metabolism product of ISDN
similar ADR, tolerance, and DDI as GTN
dosage form: tablet
Ranolazine
blocks late Na channels (funny Na) resulting in decreased intracellular Na, which has a stimulatory effect on Na/Ca exchanger. Ca levels now decrease leading to dec contraction during diastole putting less pressure on coronary arteries and thus lessening angina
negative inotrope
Use: chronic stable angina
prescribed if beta blocker was contraindicated or unsuccessful
CYP 3A4 and CYP 2D6 metabolism
DDI:
CYP agents = diltiazem, verapamil, grapefruit juice, ketoconazole, macrolide, and protease inhibitors
QT interval increasers = antiarrhythmics, bepridil, thioridazine, and ziprasidone
CYP 2D6 = TC antidepressants, antipsychotics, SSRI
ADR: dizzy, HA, edema, hypotension, bradycardia, constipation, fainting, palpitations, tinnitus, vertigo, ab pain, vomit, dry mouth, dec HCT
