Stable ischemic disease part 4

Question 1

Nitrates and Nitrites
Nitroglycerin
Isosorbide dinitrate
Amyl nitrite

Question 2

Nitroglycerin

For acute episodes
Been used in medicine for more than 130 years
Sublingual tablets Rapid onset 1-3 min; duration 30-60 min

Question 3

Nitrates and Nitrites

Venous vasodilator” ↓ Preload ↓ Wall stress ↓ O2 demand

Arterial vasodilator at higher doses increase Coronary blood flow
increase O2 supply

Question 4

Nitric Oxide (NO)
Vasodilation in veins at low doses
Vasodilation in arteries at higher doses

Previously known as endothelium-derived relaxation factor (EDRF)
Coronary blood flow (increase O2 supply)
Reduction in venous tone
decrease Preload
decrease CO & Wall stress
increase O2 demand

Question 5

Nitrates: Adverse Effects

Notorious for causing headaches–>Meningeal arterial dilation
Development of tolerance
Orthostatic hypotension–> Reflex tachycardia
Syncope