Antianginal Drugs Garrett J. Gross
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Myocardial Preconditioning <ul><li>Single or multiple brief periods of ischemia result in a marked reduction in infarct si...
&quot; Decrease in the effect of a drug when administered in a long-acting form&quot; NITRATES TOLERANCE Develops with all...
 
NITRATES CONTRAINDICATIONS Previous hypersensitivity Hypotension ( < 80 mmHg) AMI with low ventricular filling pressure  1...
 
ß-ADRENERGIC BLOCKERS CONTRAINDICATIONS Hypotension: BP < 100 mmHg Bradycardia: HR < 50 bpm Chronic bronchitis, ASTHMA Sev...
 
 
Reasons for Using Nitrates and Beta Blockers in Combination in Angina <ul><li>Beta Blockers prevent reflex tachycardia and...
 
 
 
Upcoming SlideShare
Loading in...5
×

lect-anian

1,841

Published on

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
1,841
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
421
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide
  • lect-anian

    1. 1. Antianginal Drugs Garrett J. Gross
    2. 16. Myocardial Preconditioning <ul><li>Single or multiple brief periods of ischemia result in a marked reduction in infarct size when the hearts are exposed to a more prolonged period of ischemia. </li></ul><ul><li>Has 2 phases:Acute and Delayed PC </li></ul><ul><li>Acute phase lasts 1-2 Hours </li></ul><ul><li>Delayed phase lasts 24-72 Hours </li></ul><ul><li>Nitrogycerin(GTN) produces delayed PC in animal and clinical studies. </li></ul><ul><li>This effect persists even in the presence of tolerance to its vasodilator effects </li></ul>
    3. 17. &quot; Decrease in the effect of a drug when administered in a long-acting form&quot; NITRATES TOLERANCE Develops with all nitrates Is dose-dependent Disappears in 24 h. after stopping the drug Tolerance can be avoided - Using the least effective dose - Creating discontinuous plasma levels
    4. 19. NITRATES CONTRAINDICATIONS Previous hypersensitivity Hypotension ( < 80 mmHg) AMI with low ventricular filling pressure 1 st trimester of pregnancy WITH CAUTION: <ul><li>Constrictive pericarditis </li></ul><ul><li>Intracranial hypertension </li></ul><ul><li>Hypertrophic cardiomyopathy </li></ul>
    5. 21. ß-ADRENERGIC BLOCKERS CONTRAINDICATIONS Hypotension: BP < 100 mmHg Bradycardia: HR < 50 bpm Chronic bronchitis, ASTHMA Severe chronic renal insufficiency
    6. 24. Reasons for Using Nitrates and Beta Blockers in Combination in Angina <ul><li>Beta Blockers prevent reflex tachycardia and contractility produced by nitrate-induced hypotension. </li></ul><ul><li>Nitrates prevent any coronary vasospasm produced by Beta Blockers. </li></ul><ul><li>Nitrates prevent increases in left ventricular filling pressure or preload resulting from the negative inotropic effects produced by Beta Blockers. </li></ul><ul><li>Nitrates and Beta Blockers both reduce myocardial oxygen consumption by different mechanisms. </li></ul><ul><li>Nitrates and Beta Blockers both increase subendocardial blood flow by different mechanisms </li></ul>
    1. A particular slide catching your eye?

      Clipping is a handy way to collect important slides you want to go back to later.

    ×