Vasodilators (lec 18)

Question 1

Classic Angina is?

Answer 1

Atherosclerotic obstruction of large coronary vessels

EXERCISE induced

Question 2

Variant Angina is?

Answer 2

Spastic constriction of artherosclerotic coronary vessels

Question 3

Myocardial Ischemia caused by?

Answer 3

imbalance of O2 supply/demand

↑ in HR or contractility -> ↑ O2 demand

Question 4

O2 supply to heart directly related to?

Answer 4

blood flow

Question 5

Rate of coronary blood flow directly/proportionally related to? (2)

Answer 5

Perfusion pressure

Diastole duration

Question 6

Coronary Blood Flow ↓ by?

Answer 6

1) ↑ HR -> shorten duration of diastole
2) ↑ vent end-diastolic pressure
3) ↓ diastolic arterial pressure

Question 7

Primary mechanism for manipulating O2 needs?

Answer 7

Δ Oxygen Demand by manipulating:

Heart Rate
Contractility
Wall Tension

Question 8

Heart Rate Δs affect O2 needs how?

Drug types?

Answer 8

↓ HR -> ↓ O2 demand

β-block, Ca2+ chan block

Question 9

Contractility Δs affect O2 needs how?

Drug types?

Answer 9

↓ contractility -> ↓ O2 demand

β-block, Ca2+ chan block

Question 10

Wall Tension Δs affect O2 needs how?

Drug types?

Answer 10

Tension affects Vent vol and pressure (preload and afterload):

↓ Preload or afterload -> ↓ O2 demand

NO: preload
CCB: afterload

Question 11

Effective tx of Angina results in?

Answer 11

↑ exercise tolerance

↓ frequency/duration of ischemia

Question 12

Best tx for Variant Angina?

Answer 12

Nitrates/CCB

β-block Φ dilate spastic vessels

Question 13

Best overall Angina tx?

Why?

Answer 13

Nitrate/β-block/CCB combo

Nitrates counter β-block/CCB S/E
β-block/CCB counter Nitrate reflex tachy