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20 Cards in this Set
- Front
- Back
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What are the 4 types of Angina?
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Typical (Stable, Effort)
Variant (Prinzmetal) Unstable Microvascular |
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What is the major form of angina?
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Typical (Stable, Effort) angina- increased O2 demand, fixed supply
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What type of angina is caused by a (sudden) decrease in O2 supply (coronary spasms), but the demand is unchanged?
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Variant (Prinzmetal) angina
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What is the most dangerous form of angina, usually occurs at rest, causes a decrease in O2 supply and blood flow due to a blood clot and leads to an acute emergency?
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Unstable angina (acute coronary syndrome)
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What is Microvascular angina (Syndrome X) caused by?
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Atherosclerosis in a small coronary artery, similar to Stable Angina
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What are the frontline agents for treating angina?
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Beta-blockers, Calcium channel blockers, and Nitrates
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What is the major determinant of myocardial O2 supply?
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Coronary blood flow
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What is the only way to increase O2 delivery?
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Increase coronary blood flow
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Which agents work by relaxing the resistance vessels (decrease TPR)?
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Nitrates, CCBs, and some Beta-blockers
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Which agent works by relaxing the capacitance vessels (decrease venous return)?
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Nitrates
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Which agents work by blocking sympathetic influence on the heart (decreased contractility)?
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Beta-blockers
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Which agent causes coronary vessel dilation?
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Nitrates
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What is the mechanism of action of Nitrates?
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Increase NO --> increase cGMP --> increase Ca uptake by SR --> muscle relaxation
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How does tolerance develop with Nitrates?
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formation of disulfide bonds in sulfhydral groups (break from medication is needed to reverse tolerance by conversion back to sulfhydral groups)
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What medication is contraindicated with Nitrates?
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Sildendafil (Viagra)- phosphodiesterase type 5 inhibitor, which increase NO and cGMP
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What routes of administration of Nitroglycerin are used for an acute attack vs. chronic treatment?
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Acute attack- sublingual tablet/ translingual spray
Chronic treatment- oral/ transdermal patch |
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What class of drugs is contraindicated in people with heart failure?
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CCBs
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What class of drugs is frontline for people with angina and a pervious MI?
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Beta-blockers
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What class of drugs should most likely be avoided in people with asthma or diabetes?
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Beta-blockers
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What are two classes of drugs that can be used to treat both hypertension and angina?
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Beta-blockers and CCBs
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