Week 3 - CHD

Question 1

How do nitro-vasodilators work?

Answer 1

-produce NO (nitric oxide) which increases cGMP (in muscle cells) –> muscle relaxes/dilates

Question 2

What is the most common vasodilator (nitrate)?

Answer 2

GTN

-sublingual tablet, spray, transdermal patch

Question 3

Where does GTN work?

Answer 3

Nitrovasodilators dilate both arteries and veins

Question 4

What are common unwanted effects of nitrovasodilators?

Answer 4

• throbbing headache - cerebral vasodilation
• dizziness - esp. on getting up = low BP

Caution with:

• other drugs that lower BP
• other drugs acting on NO pathway - e.g. Sildenafil

Question 5

What is the mechanism of action of lipid lowering drugs (statins)?

Answer 5

HMG-CoA reductase inhibitors but may work via other mechanisms

HMG-CoA is involved in cholesterol synthesis

Question 6

What are the side effects of lipid-lowering drugs (statins)?

Answer 6

• GI upset (usually wears off)
• abnormal liver tests (usually mild)
• muscle problems (myopathy - rare but serious)

Question 7

Where does the pain from angina result from?

Answer 7

Cardiac ischaemia