PHARMA - ANGINA PECTORIS Flashcards
A pain that occurs in the chest region during ischemic heart disease
Angina pectoris
The painful symptoms inherent to angina pectoris seem to result from the accumulation of metabolic by-products such as __
Lactic acid
Three group of drugs typically used to treat symptoms of angina pectoris
Organic nitrates, Beta blockers, and Calcium channel blockers
Consists of drugs such as Nitroglycerin, Isosorbide Dinitrate, Isosorbide mononitrate, Erythrityl tetranitrate, Pentaerythritol tetranitrate, and Amyl nitrate
Organic Nitrates
This causes vasodilation by increasing the production of cGMP within the muscle cell
Nitric oxide
It acts as a second messenger that inhibits smooth-mm contraction by initiating phosphorylation of specific contractile proteins
Cyclic GMP
The primary way that these drugs relieve angina pectoris to through their ability to decrease cardiac work, thus decreasing myocardial oxygen demand
Organic nitrates
A powerful explosive drug that is most well-known antianginal drug
Nitroglycerin (NBitro-bid)
Best method of administration of nitrogylcerin to treat an acute attack of angina
Sublingual
Long acting nitrates
Isosorbide Dinitrate
Treatment of acute episodes of angina and for the prevention of anginal attacks
Isosorbide Dinitrate
Typically given orally for prevention of anginal attacks
Isosorbide Mononitrate
Can be inhaled during acute anginal attacks
Amyl Nitrate
Adverse effects of Organic nitrates
Dizziness, headaches, nausea, and orthostatic hypotension
Decrease heart rate and the force of myocardial oxygen demand
Beta blockers/ beta-adrenergic blockers
Help certain pts c angina by maintaining an appropriate balance between myocardial oxygen supply and demand by preventing an increase in myocardial oxygen demand
Beta blockers/ beta-adrenergic blockers
Cardioselective beta antagonists
- Atenolol (Tenormin)
- Metropolol (Lopressor)
Can be given to pts c angina who also have hypertension
Carvedilol (Coreg)
Adverse effects include induced bronchochonstriction in pts c asthma or similar respiratory problems
Beta blockers / beta-adrenergic blockers
These drugs block the entry of calcium into vascular smooth mm
Calcium channel blockers
It also affect the myocardial excitability by altering the conduction of electrical activity throughout the myocardium
Calcium channel blockers
Which of these affect vascular smooth mm more than myocardial tissues
- Dihydropyridine agents
- Nondihydropyridine calcium channel blockers
Dihydropyridine agents (Nifedipine, other -ipine drugs)
Nondihydropyridine calcium channel blockers
Diltiazem and Verapamil
These drugs are advantageous in the tx of pts c angina who also have certain types of cardiac arrhythmias
Nifedipine (Adalat) and other dihydropyridines
It decreases calcium concentration in hear mm cells
Ranolazine (Ranexa)
The effect of this drug decreases calcium concentration in heart cells via a mechanism involving the sodium-calcium exchanger
Ranolazine (Ranexa)
Drug that is typically reserved for pts who have not responded adequately to more conventional agents in the tx of angina
Ranolazine (Ranexa)
This inhibits the biosynthesis of prostaglandins (responsible for activating platelets during the clotting process)
Aspirin
Often used during the initial or acute phase of unstable angina to prevent clot formation at atherosclerotic plaques that may have ruptured in the coronary arteries.
Heparin
Adverse effect of Nifedipine and Dihydropyridine)
Reflex tachycardia
Most common form of ischemic heart disease
Stable angina
Myocardial oxygen demand greatly exceeds oxygen supply
Stable angina
Stable angina is often referred to as ___
Effort / exertional angina
First drugs used in the long-term management of stable angina
Beta blockers (decrease the workload of the heart)
Drugs that can be used in the tx of stable angina:
- beta blockers
- organic nitrates
- calcium channel blockers
- ranolazine (ranexa)
Oxygen supply to the myocardium decreases because of coronary artery vasospasm
Variant angina (Prinzmetal ischemia)
Drugs that can be used in the tx of variant angina
- calcium channel blockers
- long acting nitrates
- short-acting nitrates
The most severe form of angina
Unstable angina
The most serious and potentially dangerous form of angina
Unstable angina
