Angina Drugs

Front 1

Organic Nitrates

1)MOA
2)CU
3)AE
4)Contra

Back 1

1) causes coronary vasodilation -> inc perfusion to myocardium

dilation of large veins -> dec preload -> dec work of heart -> dec O2 consumption

2) Stable, Unstable, and Variant Angina

3) Hypotension; Can develop tolerance because vessel desensitize to vasodilation (can fix via daily drug free intervals)

4) Sildenafil because it blocks phosphodiesterase, which normally breaks down cGMP. Thus get inc cGMP, causing TOO MUCH vasodilation

Front 2

Nitroglycerin

1)MOA

2)Use / Duration of Action

Back 2

1)Nitrate-> converted to NO -> activated guanylate cyclase -> inc cGMP -> dephosphorylation of myosin ->relax vascular smooth muscle ->vasodilate

2)Given Sublingual Spray / 1min

Front 3

Isorbide Mononitrate

1) MOA

2)Use / Duration of Action

Back 3

1)Nitrate -> metabolized to antianginal metabolite with longer half life

2)Given Sublingual Spray/ longer duration then nitroglycerin

Front 4

Sodium Nitroprusside

1)MOA

2)CU

3)AE

Back 4

1)Nitrate -> a DIRECT NO donor ->very effective immediate vasodilator

2)Treat HTN EMERGENCY

3)Must protect it from light because it converts drug to cyanide

Front 5

Beta Blockers

1)MOA

2)CU

3)AE

Back 5

1)dec rate and force of contraction of heart -> reducing O2 demand

2)Reduces freq and Severity of Angina
Prophylaxis in MI Patients

3)Asthma, Diabetes Mellitus, COPD, Vascular Disease, Variant Angina

Front 6

Propranolol

Back 6

B Blocker, dont use because NOT CARDIOSELECTIVE

Front 7

Metoprolol

Back 7

B Blocker, cardioselective

Front 8

Atenolol

Back 8

B Blocker Cardioselective

Front 9

Nifedipine

1)MOA
2)CU

Back 9

Ca2+ Channel Blocker
1)In ischemia, Ca is increased in ischemia d/t hypoxia induced depolarization. Thus, these blockers dec Ca -> dec smooth muscle tone->vasodilation->dec BP (NO EFFECT ON CARDIAC CONDUCTION OR HR)

2)Prophylaxis for Angina

Front 10

Nicardipine
1)MOA
2)CU

Back 10

Ca2+ Channel Blocker
1)In ischemia, Ca is increased in ischemia d/t hypoxia induced depolarization. Thus, these blockers dec Ca -> dec smooth muscle tone->vasodilation->dec BP (NO EFFECT ON CARDIAC CONDUCTION OR HR)

2)Prophylaxis for Angina

Front 11

Felodipine

1)MOA
2)CU

Back 11

Ca2+ Channel Blocker
1)In ischemia, Ca is increased in ischemia d/t hypoxia induced depolarization. Thus, these blockers dec Ca -> dec smooth muscle tone->vasodilation->dec BP (NO EFFECT ON CARDIAC CONDUCTION OR HR)

2)Prophylaxis for Angina

Front 12

Amlodipine

1)CU

Back 12

Ca2+ Channel Blocker that does not affect HR or Cardiac Output

Front 13

Verapamil

1)CU

2)AE

3)Contra

Back 13

Ca2+ Channel Blocker
1) Slows AV conduction directly -> decr HR,contractility,BP -> dec O2 demand

2)Displaces digoxin ->Inc digoxin levels

3)Preexisting Depressed Cardiac Function or AV Conduction Problems

Front 14

Diltiazem
1)CU
2)AE
3)Contra

Back 14

Ca2+ Channel Blocker
1) Slows AV conduction directly -> decr HR,contractility,BP -> dec O2 demand

2)Displaces digoxin ->Inc digoxin levels

3)Preexisting Depressed Cardiac Function or AV Conduction Problems

Front 15

Ca2+Channel Blockers

1)MOA

Back 15

1) 1)In ischemia, Ca is increased in ischemia d/t hypoxia induced depolarization. Thus, these blockers dec Ca -> dec smooth muscle tone->arteriolar vasodilation->dec BP

Front 16

Ranolazine

1)MOA

2)CU

3)AE

Back 16

Na Channel Blocker

1)blocks inward Na current ->less Na in cell -> more functional Na/Ca exchanger -> inc in Ca OUT of cell -> dec Contractility -> dec O2 demand

2)Angina Prophylaxis

3)Prolonged QT interval

Front 17

Angina Classifications:

1) Class 1
2) Class 2
3) Class 3
4) Class 4

Back 17

1)Angina on strenuous exercise
2)Angina on walking up stairs rapidly
3)Angina climbing one flight of stairs at normal pace
4)Angina all the time

Front 18

Treatment of Choice for Stable Angina

Back 18

Maintenance Therapy:
Long Acting Nitrates
Ca2+ Channel Blockers
Beta Blockers

Front 19

Treatment of Unstable Angina

Back 19

Nitroglycerin AND Beta Blockers

Front 20

Treatment of Variant Angina

Back 20

Nitroglycerin AND Any Calcium Channel Blocker

Front 21

1)When treating angina, when should you not use Beta Blockers?

Back 21

when also have diabetes, asthma, or COPD

Front 22

1)When treating angina, when should you not use Ca2+ Channel Blockers

Back 22

when have had a recent MI

Front 23

1)How to treat Mild HTN
2)Treat Severe HTN?

Back 23

1)With Single Drug
2) More than one drug

Front 24

1)Single Drug Therapy to Treat HTN

2)Combo Therapy

3)Triple Therapy

Back 24

1) Thiazides

2)Combine Thiazide with Beta blockers/Ca Channel Blocker/or ACE Inhibitor

3)Add Furosemide of Clonidine