Med Chem - Ischemic Heart Disease (IHD) Flashcards
ischemic heart disease can also be called….
CAD (coronary artery disease) or atherosclerotic heart disease
explain what ischemic heart disease is
reduced blood flow to the heart bc of plaque buildup in the coronary arteries. reduced O2 supply to the heart
true or false
ischemic heart disease is usually asymptomatic until the disease reaches an advanced stage
true
name the 3 types of ischemic heart disease and explain the difference between them
stable IHD - angina pectoris only when exerting or exercising
unstable IHD - patient has chest pain AT REST
prinzmetal’s angina - coronary vasospasm
name 7 classes of drugs that can be used in IHD
nitro vasodilators
ranolazine
b blockers
calcium channel blockers
ACE inhibitor/ARB
ivabradine
what are the 2 methods of NO synthesis
(just name them dont explain yet)
enzymatic (endogenous)
dietary
*explain the dietary synthesis of NO
nitrate (NO3-) gets reduced to nitrite (NO2-) through the enzyme in the oral flora called NITRATE REDUCTASE
then, nitrite (NO2-) spontaneously decomposes in an acidic environment (like the stomach) into NO
*explain the endogenous/enzymatic synthesis of NO
L-arginine, with oxygen, is converted to N-hydroxyarginine
N-hydroxyarginine then produces L-citrulline (released from endothelial cells) + nitric oxide
what kind of food is rich in nitrates
beets
“enterosalivary nitrate circulation”
the dietary synthesis of no
**EXPLAIN the MOA of NO donor vasodilators
the release of NO activates guanylyl cyclase – INCREASING cGMP production
this increased cGMP activates myosin phosphatase – results in smooth muscle relaxation
true or false
when myosin is phosphorylated, smooth muscle contracts
true
true or false
nitro vasodilators activate phosphatases
true
how does nitric oxide stimulate the production of cGMP
by interacting with the heme on guanylyl cyclase
guanylyl cyclase is a heterodimeric heme protein
which subunit contains the B=binding domain
the B subunit
