Lecture 12 - Anti-Anginal Therapies Flashcards

1
Q

Nitrates and Nitrites relax VSMC –> vasodilation. Which vessels feel the greatest effect?

A

Veins&raquo_space; Large arteries&raquo_space; Arterioles

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2
Q

Nitroglycerin is metabolized by mitochondrial ______ _______, releasing NO. Dilation of veins causes pooling of blood in large veins –> less venous return to the heart –> decrease in _____ _____ volume (effectively decreases Pre-load).

A

Aldehyde Dehydrogenase

End Diastolic Volume

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3
Q

At high doses, Nitrates/Nitrites dilate arterioles –> decreases systemic BP –> decreases ____load. The combination of venous and arteriolar dilation decreases myocardial oxygen demand.

A

Afterload

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4
Q

Nitrates and Nitrites also increase intracellular c_____, which results in NO production and VSMC relaxation (vessel dilation.)

A

cGMP

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5
Q

______ hypotension, Reflex ______, Skin flushing, and headache are possible side effects of Nitrates/Nitrites.

A

Orthostatic hypotension

Reflex Tachycardia

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6
Q

Sildenafil inhibits _________ type 5, so there’s less breakdown of cGMP –> more NO production. Because Nitrates do the same, so these patients should NOT take them for risk of Hypotension.

A

Phosphodiesterase type 5

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7
Q

Propranolol and Metoprolol are both ______ (hydro or lipophilic?), so they can cross the BBB. Thus, they can cause lethargy and depression.

A

Lipophilic

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8
Q

Beta blockers can cause side effects including Bradycardia, _______ (think of where they act in the lungs), fatigue, and sexual dysfunction.

A

Bronchospasm

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9
Q

Ranolazine likely acts by inhibiting the late ____ channel current –> decrease in intracellular _____ –> decrease Ca++ influx –> decrease VSMC contraction.

A

Na+ channels

Na+

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