Pharmacology of Anti-Anginals

Question 1

What ADRs are most associated with nitroglycerin?

Answer 1

Orthostatic hypotension, tachycardia

Question 2

Calcium channel blockers decreased HR. They also preferentially decrease the tone of (arteries/veins).

Answer 2

Arteries - to decrease afterload

Question 3

Beta blockers cause cardiac depression. What purpose does this serve in treating angina?

Answer 3

Cardiac depression reduces the O2 demand of cardiac myocytes

Question 4

Beta blockers should not be used to treat what type of angina?

Answer 4

Prizmetal angina

Question 5

What drug is a selective beta 1 blocker?

Answer 5

Metoprolol

Question 6

What is the MOA of nitroglycerin?

Answer 6

Increases NO to relax smooth muscle and cause vasodilation.

Question 7

Nitroglycerin preferentially acts on (arteries/veins) to reduce (afterload/preload).

Answer 7

Veins & preload

Question 8

What ADR is most commonly associated with verapamil?

Answer 8

Constipation

Question 9

True/False. Coronary arteries fill during systole.

Answer 9

False - they fill during diastole when the heart relaxes

Question 10

What antianginal medication should not be used it patients with prinzmetal angina?

Answer 10

Beta blockers - non-specific blockers cause vasoconstriction

Question 11

Vasodilators may cause a “coronary steal” effect. What does this mean?

Answer 11

Atherosclerotic coronary arteries do not dilate normally. Vasodilators dilate normal vessels, but not atherosclerotic arteries, leading to increased flow to healthy areas and decreased flow to ischemic areas

Question 12

What calcium channel blockers possess primarily vasculature effects?

Answer 12

Amlodipine, nifedipine

Question 13

Beta blockers are contraindicated in patients with these conditions.

Answer 13

Asthma, COPD, severe bradycardia

Question 14

For treating angina, what two drug class combinations result in additive effects on cardiac force?

Answer 14

Non-DHP calcium channel blockers and beta blockers

Question 15

Caution should be exercised when administering nitroglycerin to what patients?

Answer 15

Contraindicated in patients with migraines and caution with patients taking erectile dysfunction medications

Question 16

What Calcium channel blockers are have both cardiac and vasodilatory effects?

Answer 16

Verapamil, diltiazem

Question 17

Nitroglycerin preferentially acts on which vessels?

Answer 17

Veins to decrease preload and end diastolic pressure