Treatment of Angina

Question 1

Nitrate MOA

Answer 1

Endothelial NO activates GC–>increases cGMP–>de-PP of MLCK–>relaxation of VSM

Venodilation–> decreases preload and afterload–>decreases myocardial O2 demand

Question 2

Nitrate indications

Answer 2

Acute angina (nitroglycerin)
pulmonary edema

Question 3

Nitrate side effects

Answer 3

reflex tachycardia
orthostatic hypotension
headache
tachyphylaxis

Question 4

CCBs MOA

Answer 4

inhibit voltage-gated L-type Ca channels and decreases Ca influx in cardiac and VSM; decreases muscle contractility

arteriolar vasodilation–> decreases afterload–> decreases myocardial O2 demand–>decreases AV node conduction

Question 5

CCBs indications

Answer 5

angina
HTN
SVT (except nifedipine)

Question 6

CCBs side effects

Answer 6

cardiac depression
peripheral edema
constipation

Question 7

BBs MOA

Answer 7

beta-adrenergic antagonism

decreased contractility, dec. HR, dec BP (mild), dec myocardial O2 demand, dec AV node conduction velocity

Question 8

BB indications

Answer 8

Angina
HTN
arrhythmia

Question 9

BB side-effects

Answer 9

impotence
depression
bradycardia