Myocardial Drugs

Question 1

Describe the type of pain associated with myocardial ischemia.

Answer 1

Sudden
Severe
Pressing chest pain from
Substernal, radiating to left arm.

Question 2

What are the 4 Principal Goals of therapy when treating myocardial ischemia?

Answer 2

1) Correct O2 demand
2) Improve coronary artery circulation
3) reduce ionotropic (force) and chronotropic (rate) activity of myocardium - O2 demand
4) Stop formation of fibrin clot and progression of thrombus (Prevent myocardial infarction)

Question 3

Which Coronary syndrome does GTN not relieve pain?

Answer 3

Stable Angina

Question 4

What are coronary vasodilators?

Answer 4

1) Nitroglycerin and Organic Nitrates
2) Calcium Channel Blockers
3) Potassium Channel openers
4) Adenosine Receptors agonists
5) Phosphodiester inhibitors

Question 5

How do Nitroglycerin and Organic Nitrates dilate blood vessels?

Answer 5

It works by releasing nitric oxide, which relaxes and dilates the coronary arteries, improving blood flow to the heart.

Question 6

How do Calcium Channel Blockers dilate the blood vessels?

Answer 6

Calcium channel blockers (CCBs) are medications that block the influx of calcium into the smooth muscle cells of blood vessels, leading to their relaxation and subsequent vasodilation.

Question 7

How do Potassium Channel Openers Dilate BV?

Answer 7

Potassium channel openers, like nicorandil, activate potassium channels in smooth muscle cells, causing relaxation and dilation of coronary arteries. They also have a nitrate-like effect, releasing nitric oxide and enhancing blood flow to the heart.

Question 8

How do Adenosine Receptor Agonists work?

Answer 8

Adenosine and its analogs, such as adenosine and dipyridamole, act as coronary vasodilators by activating specific adenosine receptors in the coronary arteries. This activation leads to relaxation and increased blood flow in the coronary circulation.

Question 9

How do phosphodiesterase Inhibitors dilate the blood vessels?

Answer 9

Certain phosphodiesterase inhibitors, like milrinone, have vasodilatory effects on coronary arteries. They work by inhibiting the breakdown of cyclic adenosine monophosphate (cAMP), a molecule that promotes relaxation of smooth muscles, including those in the coronary arteries.