Pharmacology: Anti anginal drugs flashcards


Published on

Excellent study aid for medical, pharmacy, nursing, university, and college students!

  • Be the first to comment

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide

Pharmacology: Anti anginal drugs flashcards

  1. 1.  Amyl Nitrite  Nitroglycerin (duration depends on administration)  Isosorbide mononitrate (long duration, great bioavailability)
  2. 2.  MoA: denitrated by glutathione releasing free nitrites which are converted to NO which increase cGMP  dephosphorylation of MLCK and decrease in [Ca] in cell  Actions   Decrease O2 demand by decreasing preload (relaxation of large veins - VENODILATOR) Increase O2 delivery by relieving coronary spasm  Tolerance appears rapidly but disappears rapidly too  DO NOT WITHDRAW FROM PTS WHO ARE ON THEM FOR YEARS
  3. 3.  Adverse       Reflex tachycardia and postural hypotension with high doses Increased cGMP = decreased platelet aggregation Nitrites = methemoglobin formation Throbbing HA, dizziness, flushing (prevent with NSAIDS) Hypotension w/ sildenafil (viagara) Contraindicated in hypertrophic cardiomyopathy (preload is already reduced)
  4. 4.  Tx and prevention of acute attack (sublingual)  Chronic prophylaxis  Relieve pulmonary congestion  Cyanide poisoning (amyl nitrite produces methemoglobin which complexes with cyanide)
  5. 5.  Propranolol; Metoprolol  MoA: decrease O2 demand by decreasing contractility and heart rate  Actions   Decrease cardiac O2 demand Increase myocardial perfusion because of increased diastolic perfusion time
  6. 6.  Adverse    Increased EDV  increased Ejection time Withdrawal effects Interact with calcium channel blockers which act on the heart or P450 inducers/inhibitors  Uses   Myocardial Infarction Chronic prophylaxis of exertional angina (not effective in variant angina)
  7. 7.  Nifedipine  selectivity for vessels only  Diltiazem  & Nimodipine & Verapamil selectivity for heart and vessels  MoA:     Decrease O2 demand by decreasing afterload, contractility, and heart rate Increase O2 delivery by relieving coronary spasm Diltiazem and verapamil: decrease automaticity vasodilation
  8. 8.  Adverse       HA and dizziness Flushing and peripheral edema Profound hypotension (coronary steal phenomenon with nifidepine!), tachycardia Verapamil = constipation & gingival hyperplasia Adverse effects with B-blockers Uses Good for exertional angina by decreasing O2 demand  Variant angina because they increase myocardial O2 supply  Hypertension  DOC for Raynaud’s Phenomenon 
  9. 9.  Aka prinzmetal or vasospastic angina is due to large vessel spasm  Occurs regularly or certain times of the day and there is pain at rest
  10. 10.  B-blockers and nitrates work because Bblockers can prevent reflex tachycardia and increased tachycardia while the nitrates prevent increased EDV and ejection time  Nitrates and Ca-channel blockers work because of similar reasoning
  11. 11. If you enjoyed this presentation, please take a look at the rest of our products. Our website has many more FREE excellent presentations and tons of other FREE information. HIGHSCORE: Must Know Pharmacology Description: This is a book of 400+ flashcards covering 20 highly tested, and high-yield topics in pharmacology. It is designed so that you can use it anywhere on any device or print it out and use as flashcards. Get the eBook: HERE! Our site: Exam Masters Tutoring Service
  12. 12. HIGHSCORE: Comparisons of High Yield Topics for the Medical Boards Description: This book contains over 100 comparisons of some of the most highly tested diseases and topics on the USMLE Step 2 CK. The questions on the exam are much more vague than what you see in the practice question banks and it is very difficult to differentiate between two diseases with similar symptoms. So this book is designed to help students improve their score by targeting these types of difficult questions. Get the Free Sample: HERE! Get the whole eBook: HERE!
  13. 13. USMLE STEP 2 CK TIDBITS & TIPS MONTHLY SUBSCRIPTION Join hundreds of other students preparing for the USMLE Step 2 CK on our USMLE Step 2 CK Tidbits & Tips newsletter! It is an amazing newsletter with tons of great info. The monthly subscription entails a weekly newsletter with info such as high yield disease comparisons, most commonly tested facts, treatments & management, and much more! View a sample Newsletter: HERE! Subscribe to this awesome Newsletter: HERE!