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second year > pharmacological treatment of angina > Flashcards

pharmacological treatment of angina Flashcards

1
Q

what are the three different classes of angina?

A

variant (prinzmetal) angina
stable (chronic) angina
unstable angina

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2
Q

what causes variant (prinzmetal) angina?

A

coronary artery spasm

may be related to sympathetic nerve supply to the coronary arteries

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3
Q

what causes stable (chronic) angina?

A

fixed narrowing of coronary arteries

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4
Q

what causes unstable angina?

A

formation of a thrombus around ruptured atherosclerotic plaque

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5
Q

which class of angina occurs on exertion?

A

stable angina

coronary blood flow is met at rest but cannot meet oxygen demands with exertion

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6
Q

which two classes of angina are defined as SUPPLY ISCHAEMIA?

A

variant angina and unstable angina

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7
Q

what type of ischaemia is stable angina defined as?

A

demand ischaemia (exertion increases the oxygen demand on cardiac muscle)

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8
Q

what are three different changes which result in a shorter window to supply the heart with blood via the coronary arteries?

A
  • shortening diastole
  • increased ventricular end diastolic pressure
  • decreasing arterial diastolic pressure (e.g. mitral or aortic valve incompetence or heart failure)
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9
Q

what is the definition of angina pectoris?

A

chest pain due to inadequate supply of oxygen to the heart

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10
Q

where is the characteristic distribution of angina chest pain?

A

chest, arm, jaw and neck

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11
Q

what is the main mechanism of action of abtianginal drugs?

A

mainly work by decreasing the metallic demands of the heart muscle

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12
Q

how do vasodilators decrease the metabolic demands of the heart?

A

decrease preload therefore decrease the work the heart has to do to refill the ventricles
decrease after load (pressure in the aorta) - decreasing the work the heart has to work to push against - decrease total peripheral resistance

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13
Q

what are the three main vasodilators of the heart?

A

organic nitrates, nicorandil (potassium channel activator) and calcium antagonists

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14
Q

what two drugs slow down the heart rate?

A

beta blockers and ivabradine

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15
Q

what are the two beta blockers commonly used in the treatment of angina?

A

bisoprolol and atenolol

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16
Q

what type of channel do calcium channel inhibitors prevent from opening?

A

L-type calcium channels

17
Q

what are the two dihydropyridine derivative calcium antagonists?

A

Amlodipine

Lercanidipine

18
Q

what are the two rate-limiting calcium antagonists?

A

Verapamil

Diltiazem

19
Q

which calcium antagonists WOULD NOT be used in conjunction with beta blockers, with patients with heart failure or an AV block?

A

Diltiazem

Verapamil

20
Q

which calcium antagonists can also be used to treat hypertension?

A

amlodipine

lercanidipine

21
Q

which calcium antagonist can be used to treat ventricular dysrhythmias?
(used to decrease ventricular rate in AF, prevents recurrence of supra ventricular tachycardia
(BUT no effect on ventricular arrythmias)

A

Verapamil

22
Q

which organic Nitrate is given sublingually to stable angina pateinets SHORTLY before exertion?

A

Glyceryl trinitrate

23
Q

which organic nitrate can be given sublingually to stable angina patients A LONG TIME BEFORE exertion?

A

Isosorbide mononitrate

24
Q

which organic nitrate can be given to patients intravenously in UNSTABLE ANGINA?

A

glyceryl trinitrate

25
Q

which organic nitrate can be given to ACUTE HEART FAILURE patients INTRAVENOUSLY?

A

glyceryl trinitrate

26
Q

which organic nitrate can be given to chronic heart failure patients in conjunction with HYDRAZINE?

A

isosorbide mononitrate

27
Q

what are two common side effects of organic nitrates?

A

headaches, postural hypotension

28
Q

what are three common side effects of calcium inhibitors?

A

headaches, constipation and ankle oedema

29
Q

what is the name of a POTASSIUM CHANNEL ACTIVATOR?

A

NICORANDIL

30
Q

what are three common side effects of nicroandil?

A

flushing, dizziness and headaches

31
Q

what type of channels does IVABRADINE inhibit, reducing cardiac pacemaker ability?

A

f-type sodium channels

32
Q

what is the name of the drug used as a last-resort in the treatment of angina?

A

Ranolazine

second year (24 decks)

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