Tx of Angina Flashcards
Class of drug that produces potent reduction in preload
Nitrates, reduce venous return by venodilation
Names of the non-dihydropyridine CCBs?
Verapamil, Diltiazem
Naming system of dihydropyridine CCBs?
all end in “-pine” (Nifedipine, Amlodipine, etc.)
Mechanism of action of Non-dihydropyridine CCBs?
Ca2+ channel blockers that predominately reduce heart work by decreasing HR, decreasing contractility, and slowing AV node conduction
What medication must you NEVER give with a non-dihydropyridine CCB?
Beta blocker, produces severe bradycardia
Mechanism of action of dihydropyridine?
Ca2+ channel blockers that produce potent vasodilation and reduce myocardial O2 demand by reducing afterload
What medication must be given with dihydropyridines?
Beta-blockers, they produce a potent reflex tachycardia in response to vasodilation
Situations favoring dihydropyridine use?
Sinus Bradycardia, SA/AV block, valvular insufficiency (Aortic or Mitral)
Situations favoring non-dihydropyridine use?
Asthma/Bronchospastic COPD, severe peripheral arterial disease (pain at rest), poorly controlled DM (Type I)
What significant effect do lipophilic Beta blockers have on hemodynamics?
Reduce afterload (interfere with sympathetic activation in the brain)
Which drug class has no effect on Prinzmetal angina?
Beta blockers, can even exacerbate the problem by blockade of B2-mediated coronary vasodilation
Main effect of Ranolazine?
reduces the O2 demand of the myocardium
Vitally important drug-drug interaction of Ranolazine?
can cause digoxin toxicity by inhibiting P-gp (can increase digoxin effect by 40-60%)
Ranolazine is used in which patients?
Those that are refractory and not candidates for revascularization
Mechanism of action of Nitrates?
activate guanylate cyclase–> increase intracellular cGMP–>venodilation and coronary artery dilation