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13 Cards in this Set
- Front
- Back
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What is angina pectoris? |
Result of an imbalance between the oxygen supply and demand of myocardium. |
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Manifestations if IHD |
Silent ischemia - asymptomatic Stable angina of effort and variant angina - vasospastic Acute Coronary Syndrome (ACS) a. Unstable Angina. (UA) b. Acute Myocardial Infarction (AMI) i. Non-ST-segment elevation MI (NSTEMI) ii. ST-segment elevation MI (STEMI) Chronic heart failure Sudden cardiac death |
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Classification of drugs used in Angina |
Organic nitrates Beta blockers Calcium channel blockers Potassium channel activators |
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Mechanism of anti anginal drugs |
1. Dilating the coronary arteries. 2. Reducing the cardiac workload by reducing preload and afterload. |
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Organic nitrates |
Glyceryl trinitrate Isosorbide dinitrate Isosorbide mononitrate Pentaerythritol tetranitrate |
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Glyceryl trinitrate |
A tablet of 0.3, 0.4 and 0.6 mg is given sublingually. It has an onset of 1 to 2 minutes and lasts for 15 to 40 minutes. It should be scheduled immediately.
A sustained release capsule of 2.5mg . Dosage is 2.5 to 5mg given orally. Has an onset of 60 minutes and lasts for 8 to 12 hours. Should be scheduled for 8 to 12 hours.
A sublingual spray with dosage of 0.4mg/ metered dose. Has an onset of 1 to 2 minutes and lasts for 15 to 40 minutes for three doses. Should schedule it every 5 minutes.
A 2% skin ointment - 15mg/inch. Dosage is ½ to 2 inches applied on the skin without rubbing. Onset is in 20 to 60 minutes. Lasts for 4 to 6 hours and should be scheduled as such.
Transdermal patches with a dosage of 5 to 15mg. Onset is in 30 to 60 minutes and lasts for 12 hours. Should be scheduled once daily. |
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Isosorbide dinitrate |
A tablet of 5 or 10mg. Dosage is 2.5 to 10mg given sublingually. Onset is in 10 to 30 minutes and lasts for 1 to 2 hours. Should be scheduled for 3 to 4 hours. Buccal spray with the dosage 1.25 mg/actuation. Onset is in 2 to 5 minutes. Tablet of 10, 20, 40mg. Dosage is from 10 to 40 mg given orally. Onset is in 30 to 60 minutes. Duration is for 6 to 8 hours and is scheduled every 4 hours. A sustained release tablet with dosage of 40 to 80mg given orally. Onset is in 60 minutes and lasts for 12 to 18 hours. Should be scheduled every 12 hours. |
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Isosorbide mononitrate |
A tablet of 10 to 20mg and dosage of 10 to 20 mg given orally. Onset is in 30 to 60 minutes with the duration of 6 to 8 hours. Should be scheduled ever 8 to 12 hours. |
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Adverse reactions of nitrates |
Headache Hypotension and syncope Tolerance Withdrawal symptoms |
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Adjuncts |
Cytoprotectives Antiplatelet drugs Antihyperlipidemic drugs |
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Therapeutic uses of nitrates |
All varieties of angina pectoris At the onset of pain of acute MI Paroxysmal nocturnal dyspnoea due to LVF Acute LVF Chronic Heart Failure Achalasia Cardia Acute anal fissure Cyanide Poisioning |
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Pentaerythritol tetranitrate |
A tablet with a dosage of 30mg given orally. Onset is in 15 to 30 minutes. It lasts for 4 to 6 hours and should be scheduled for every 8 to 12 hours. |
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Contraindications of nitrates |
Hypertrophic cardiomyopathy Severe aortic or mitral stenosis Obstructive pericarditis Closed angle glaucoma |
