(THER) Anti-anginal drugs Flashcards
Most frequent cause of Myocardial Ischemia
Atherosclerosis
Prinzmetal Angina
Coronary artery spasm which tends to wake patients from sleep
NO causes smooth muscle relaxation even in the abscence of _______ ____________.
Normal Endothelium
(it shows endothelium-independent relaxation)
MOA of NO
Activates Guanyl Cyclase, increasing cGMP and dephosphorylating Myosin Light Chains. This ultimately produces smooth muscle relaxation.
What effect do nitrates have on the heart/systemic circulation (4)
- Decreased Venous Return (dilates venous vessels)
- Reduced LV Wall Tension
- Reduced Afterload
- DIrect Coronary Artery Vasodilatation (increased subendocardial perfusion)
What forms nitroglycerin come in? (4)
- Sublingual
- Bucchal spray
- Patch
- Ointment
What forms do Isosorbide mono/dinitrate come in?
- Sublingual
- Chewable
- Oral
What can occur if nitrates are taken on too consistent of a basis?
The patient can develop a nitrate tolerance
How does Verapamil lead to smooth muscle relaxation?
It is a CCB so it blocks the ability of Calcium channels to cause smooth muscle contraction.
Name the (3) main CCBs
- Dihydropyridines (Nifedipine)
- Verapamil
- Diltiazem
What is the order of strength of CCBs based on their negative inotropic effects?
Verapamil > Diltiazem > Nifedipine
What is the order of strength of CCBs based on their negative chronotropic effects?
Verapamil > Diltiazem > Nifedipine
What is the order of strength of CCBs based on their Vasodilatory effects?
Nifedipine > Diltiazem > Verapamil
CCB AEs
VERAPAMIL & DILTIAZEM
- Bradycardia
- Congestive Heart Failure
- Heart Block
- Hypotension
NIFEDIPINE
- Reflex Tachycardia
- Peripheral Edema
- Hypotension
B1 receptors are coupled to ____ and ultimately cause _____ increase.
Gsa
cAMP increase
