Lecture 16 (Quiz 3)

Question 1

What is the difference between Angina Pectoris and Unstable Angina?

Answer 1

• Unstable Angina occurs when even at rest.

Question 2

What is the treatment for Angina? What drugs are used to treat Angina and side effects for each?

Answer 2

• Vasodilation and Decrease O2 consumption.
• Nitrates/Nitrites (Smooth Muscle Relaxation): Nitroglycerin (Sublingual or patches), and Amyl Nitrate (crushed fumes). Side-Effects: Hypotension, tachycardia, headache, quick tolerance develops.
• Calcium Channel-Blockers (Prevent calcium influx that reduce O2): Verapamil, Nifedipine and Diltiazem. Side-Effects: Bradycardia and dizziness.
• Beta-Blockers (NOT a vasodilator, decrease Heart stuff and O2 requirements): Propranolol and Atemolol. Side-Effects: Asthma and Acute Heart Failure.

Question 3

Which fat is good? What does it do? What lowers healthy fat levels?

Answer 3

• High Density Lipids
• Anti atherosclerotic effects
• Cigarette Smoke

Question 4

What is Hypertriglyceridemia linked to?

Answer 4

• Insulin metabolic syndromes, alcohol ingestion and high VDL and LDL levels.

Question 5

There are multiple ways to aid with Lipoprotein Disorders (Non-drug, statins, fibrates, niacin, bile acid-binding agents and inhibitors of sterol absorption), what are examples of each and what makes them unique?

Answer 5

• Non-Drug: Dietary and Exercise.
• Statins: Lovastatin, Atorvastin and Simvastatin. These reduce the synthesis of cholesterol and decrease LDL levels. Side-Effects: Liver toxicity and weakness/pain in skeletal muscles.
• Fibrates: Fenobrate. Increase oxidation of fatty acids in liver/muscles (Reduces VLDL and LDL, Increases HDL). Side Effect: GI Symptoms
• Niacin: Decreases triglycerides and LDL. Side-effect: Mild flushing and tolerance develops.
• Bile Acid-Binding Agents: Cholesteramine. Reduces reabsorption of bile acids and metabolites. Side-effects: Constipation and boating.
• Inhibitors of sterol absorption: Ezetimibe. Inhibits intestinal absorption of cholesterol and reduces LDL (can be used with Statins).

Question 6

What drugs are used to treat heart failure and what are some side effects?

Answer 6

• Digitalis, Digoxin, Milrinone, Dobutamine, Furosemide, Captopril, Hydralazine, Metoprolol.
• Effects all excitable tissues by premature depolarization and ectopic beats of heart.

Question 7

With Antiarrhythmic drugs, there are 4 classes, what does each do and what are examples?

Answer 7

• Class 1: Na channel blockers (Procainamide, Quinidine and Lidocaine, Lido=1st choice)
• Class 2: Block sympathetic autonomics of the heart (Propranolol)
• Class 3: Prolong refractory period (Amiodarone)
• Class 4: Ca channel blockers. (Verapamil and Diltiazem)