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23 Cards in this Set
- Front
- Back
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Nitrates - Common Drugs |
1. Nitroglycerin 2. Isosorbide dinitrate
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Nitrates - Indications |
Exertional angina; Varient Angina; Unstable Angina |
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Nitrates - Mechanism of Action |
Reacts with cysteinyl residues in vessel wall to increase the concentration of NO in vascular smooth muscle, causing vasodilation, esp. in venous capacitance vessels.
NO (+) > activation of guanylyl cyclase > GTP is converted to cGMP >?> activation of (?) phosphatase > dephosphorylation of Myosin-LC > relaxation |
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Nitrates - Clinical Effects |
Terminates episodes of exercise induced angina; prevents exercise induced and vasospastic angina |
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Nitrates - Adverse Effects |
Orthostatic hypotension; Reflex tachycardia; Headache; Nitrate tolerance |
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Nitrates - Contraindications |
Systematic hypotension |
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Ca Channel Blockers - Common Drugs |
1. Nifedipine 2. Nicardipine 3. Amlodipine 4. Verapamil 5. Diltiazem |
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Ca Channel Blockers - Indications |
Exertional angina; Varient Angina; Unstable Angina |
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Ca Channel Blockers - Mechanism of Action |
Blocks influx of calcium via L-Type calcium channels in vascular smooth muscle cells and cardiac myocytes, causing vasodilation, decreased contractility, HR, wall stress (lower BP), preload (venodilatation). O2 supply increased through increase coronary perfusion, and decreased vasospasm. |
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Ca Channel Blockers - Clinical Effect |
Prevents episodes of exercise-induced and vasospastic angina |
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Ca Channel Blockers - Adverse Effects |
Bradycardia; Heart block; CHF; Hypotension; Peripheral edema; reflex tachycardia (nifedipine) |
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Ca Channel Blockers - Contraindications |
Advanced heart block; CHF; Systemic hypotension |
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Beta Blockers - Common Drugs |
1. Propanolol 2. Nadolol 3. Atenolol 4. Metoprolol 5. Carvedilol |
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Beta Blockers - Indications |
Exertional angina; Unstable angina; Post MI prophylaxis |
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Beta Blockers - Mechanism of Action |
Blocks Beta-receptors in cardiac myocytes to reduce contractility.Beta Blockers - |
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Beta Blockers - Clinical Effect |
Prevents exercise-induced myocardial ischemia |
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Beta Blockers - Adverse Effects |
Bronchospasm; Peripheral vasospasm; Bradycardia; CHF; Heart block; Depression, fatigue, sexual dysfunction; blocks sympathetic response to insulin-induced hypoglycemia |
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Beta Blockers - Contraindications |
Advanced heart block; Acute CHF; Insulin-dependent diabetes mellitus; Asthma; COPD |
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Ranolazine - Indications |
Originally indicated for use in patients with chronic stable angina unresponsive to other agents; now approved for initial use in exercise-induced angina |
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Ranolazine - Mechanism of Action |
Inhibits FA beta oxidation in cardiac myocyte mitochondria - favors glucose; thereby increasing favored fuel source for diseased myocardium |
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Ranolazine - Clinical Effect |
Chronic exertional angina |
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Ranolazine - Adverse Effects |
Prolongs QT interval |
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Ranolazine - Contraindications |
Long QT syndrome; contraindicated for use with other drugs that prolong the QT interval |
