L17: Vasodilators+Angina

Question 1

CCBs effects on vessels

Answer 1

Vasodilate by relaxing all smooth muscle that depends on Ca++ for tone.

VASO>venodilation

Question 2

Why are CCBs good for chronic angina treatment but not for immediate relief?

Answer 2

B/c you need VENOdilation for acute relief

Question 3

Any drugs that _____ will decrease O2 supply

Answer 3

Decrease diastolic pressure

Increase HR

Question 4

Which meds are not effective for printzmetal’s angina?

Answer 4

B blockers bc they don’t vasodilate

Actually slow HR, increasing LV EDV, increasing CO and O2 demands

Question 5

CCBs effects on the heart

Answer 5

Negative inotrope
Reduced automatacity at SA node
Slowed AV node conduction

Question 6

Any increase in HR or contractility will…

Answer 6

increase the need for O2

Question 7

Coronary flow is decreased by

Answer 7

Shortening diastole when HR increases

Increased ventricular end-diastolic pressure

Reduced diastolic arterial pressure

Question 8

What is “Monday Disease”?

Answer 8

Explosive manufacturers chronically exposed to nitrate would get headache and dizziness on Monday but it would go away by Friday b/c they became tolerant to exposure.

Question 9

DOC for any acute angina attack - by reducing myocardial O2 requirement

Answer 9

Nitrates/Nitrites

Question 10

Nitro is given sublingually to…

Answer 10

1. Avoid hepatic destruction due to high first pass metabolism
2. Rapid absorption

Immediate angina release - onset in 1-3 min and duration 10-30 min

Question 11

Which meds are not effective for printzmetal’s angina?

Answer 11

B blockers bc they don’t vasodilate

Question 12

Nitrates/Nitrites MOA

Answer 12

Vasodilation via NO —> cGMP

UNEVEN VASODILATION - large veins are markedly dilated —> increased venous capacitance and decreased afterload

Question 13

Needed for acute relief

Answer 13

VENODILATION