Term
| 3 categories of drugs used to relieve the symptoms of angina |
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Definition
1. NO precursors-nitroglycerine and isosorbide dinitrate
2. beta blockers-propranolol
3. Calcium channel blockers-nifedipine |
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Term
nitroglycerine
-MOA
-PK and A
-Major SE |
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Definition
-especially works on veins and coronary vessels
-redistribution of coronary flow, reductions in preload, afterload, and TPR (reduce cardiac work)
MOA: converts NO which activates guanylate cyclase-->increasing cGMP-->dephosphorylation of myosin light chain-->vascular smooth muscle relaxation
PK: fast onset, large 1st pass-effect so best A is SL
SE: headache because cerebral vessel dilation
nitrite ions oxidize Hg to Methg causing reduced blood oxygen content |
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Term
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Definition
organic nitrate same MOA as nitroglycerine
-more preference for venous and decreasing preload |
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Term
propranolol
-MOA
-SE and CI |
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Definition
Non-selective B blocker
MOA: reduce HR, myocardial contracility, and O2 consumption
SE: possible worsening CHF (but also given at all stages of CHF)
worsens bronchospasms use instead metropolol (B1 selective) |
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Term
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Definition
Ca channel blocker-dihydropyridine
MOA: arteriolar vasodilator because smooth muscle relaxation->reduce TPR (afterload) and decreasing O2 demand of heart |
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Term
| What is another organic nitrate that is not used for its antianginal effects? What is it used for? |
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Definition
nitroprusside for HTN emergency
-better at vasodilating EVERYTHING (aa and vv)
SE: cyanide poisoning (of course hypotension) |
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Term
| Common combinations and rationale |
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Definition
B-blocker + nitrate=B-blockers counter the tachycardiac reflex
Nifedipine + B-blocker=counter reflex
Nitrates + Verapamil used for vasospastic and exertional angina |
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