Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CVPR Unit 2 > Vasodilators in Angina > Flashcards

Vasodilators in Angina Flashcards

1
Q

Major determinant of myocardial O2 supply is

A

Coronary Blood flow- blood flow during diastole is decreased during tachycardia (also decreased by increased LVEDP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Myocardial O2 supply is inversely proportional to

A

coronary vascular resistance- damage to endothelium can alter ability of vasculature to dilate. Vascular control by metabolites (autoregulation) is most important.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Determinants for myocardial oxygen demand

A

1) Contractile state
2) Heart rate
3) LV pressure and ventricular volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Drug that increase coronary blood flow

A

Nitrates and CCBs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Preload decreased by

A

Nitrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Afterload decreased by

A

CCBs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

-dipines properties (SA-AV Node(HR), Cardiac Muscle contractility and afterload)

A

CCBs. Inc, none to dec, dec

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Diltiazem (SA-AV Node(HR), Cardiac Muscle contractility and afterload)

A

CCB. Dec, none to dec, dec

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Verapamil (SA-AV Node(HR), Cardiac Muscle contractility and afterload)

A

CCB. Dec, Dec, Dec

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Drugs that decrease demand

A

Beta-blockers
Nitrates
Calcium Channel Blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Drugs that reduce thrombosis

A

Antiplatelet Agents - Anticoagulants

Beta-blockers – Nitrates – CCBs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Drugs that prevent vasospasm

A

Nitrates

Calcium Channel Blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Variant (Prinzmetal) Angina

A

Caused by coronary vasospasm with or without atheromatous plaque. Occurs commonly at rest.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Variant Chronic Pharmacotherapy

A

Reversing or preventing vasospasm and increasing supply with vasodilators (nitrates or Ca++ channel blockers)ion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Nitrate Pathway

A

Nitrates to NO to inc cGMP to Vasodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Nitroprusside

A

converts to NO and affects venules and aterioles (causing decreased BP)

17
Q

Increased cGMP results in

A

reduction of LVEDP and systemic vascular resistance

18
Q

Transdermal (ointment or patch), Sublingual/lingual and IV all bypass

A

First pass effect! (much higher doses for oral)

19
Q

Nitrate Adverse Rxns

A 
Throbbing headache
Orthostatic hypotension
Reflex Tachycardia
Facial Flushing
(due to vasodilation)
Tachyphylaxis (tolerance- need nitrate free interval of 6-14 hours)
20
Q

Dihydropyridines effects (nifedipine)

A

greater ratio of vascular (dilation) to cardiac (rate-conduction-contractility) effects

21
Q

Verapamil and Diltiazem (effects)

A

prominent effects at cardiac nodal tissue (phase 0 at SA and AV node) and on cardiac muscle (phase 2)

22
Q

Rapid onset -dipines may rapidly lower…?

A

BP! causes reflex activation of the SNS which leads to tachycardia, exacerbation of angina and increased risk for MI

23
Q

CCB Properties

A

1) Variable Oral bioavailability
2) Extensively protein bound
3) Metabolized by cytochrome P450

24
Q

CCB Use in Angina

A

Long-lasting decrease in peripheral vascular resistance

Reduced heart O2 requirement

Reduced coronary arterial tone (aid in vasospastic angina)

25
Q

CCB other uses

A

Arrhythmias
Hypertension
Subarachnoid hemorrhage
Inhibition of Premature labor

26
Q

Verapamil/diltiazem vs Dihydropyridines

A

Dyhydropyridines greatly increase vasodilation while not having Negative inotropic effect and suppressing AV node conduction

27
Q

CCB Adverse Rxns (verapamil/diltiazem more)

A

Cardiac arrest
Bradycardia
AV block
Congestive heart failure)

28
Q

B-Blocker Uses in Angina

A

Decreased O2 demand
Can block reflex tachycardia from use of nitrates
NOT vasodilators -> no use in variant angina

29
Q

B-Blocker Use

A

Angina patients with concomitant hypertension or arrhythmias responsive to β-blockers

30
Q

B-Blocker Contraindications

A

Asthma
Peripheral vascular disorders
Abrupt withdrawal  precipitates SNS overactivity

31
Q

Failure of Late Na+ Current Inactivation causes

A

Ischemia! Decreased O2 supply and increased demand. Caused by increased extravascular compression and diastolic wall tension.

32
Q

What drug blocks Failure of Late Na+ Current Inactivation?

A

Ranolazine. Administered bid.

33
Q

Ranolazine Adverse Rxns

A

Can Prolong QT interval

Cardiovascular effects (~ 5%): bradycardia, hypotension, palpitations, edema

34
Q

Ranolazine Use

A

Add-on to standard anti-anginal therapy

Reduces symptoms of chronic stable angina and increases exercise capacity

Can substitute for beta-blockers if not tolerated or contraindicated

CVPR Unit 2 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions