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Questions and Answers
What condition is Viagra primarily used to treat?
What condition is Viagra primarily used to treat?
What serious interaction should be considered when combining nitrates with certain medications?
What serious interaction should be considered when combining nitrates with certain medications?
What is the primary mechanism of action for beta blockers?
What is the primary mechanism of action for beta blockers?
Which of the following is a known effect of phosphodiesterase 5 inhibitors?
Which of the following is a known effect of phosphodiesterase 5 inhibitors?
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Ranolazine is primarily used in the treatment of which condition?
Ranolazine is primarily used in the treatment of which condition?
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Which type of angina is commonly known as effort-induced angina?
Which type of angina is commonly known as effort-induced angina?
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What is a characteristic feature of angina pectoris?
What is a characteristic feature of angina pectoris?
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What physiological change causes stable angina?
What physiological change causes stable angina?
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Which of the following symptoms is NOT typically associated with angina pectoris?
Which of the following symptoms is NOT typically associated with angina pectoris?
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Which condition can lead to the accumulation of acidic metabolites that cause angina?
Which condition can lead to the accumulation of acidic metabolites that cause angina?
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What is a primary mechanism of action for nitrates in the treatment of angina pectoris?
What is a primary mechanism of action for nitrates in the treatment of angina pectoris?
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Which of the following is NOT a common adverse drug reaction (ADR) associated with nitrates?
Which of the following is NOT a common adverse drug reaction (ADR) associated with nitrates?
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What condition may worsen with the use of nitrates in patients with chronic heart failure (CHF)?
What condition may worsen with the use of nitrates in patients with chronic heart failure (CHF)?
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Calcium channel blockers primarily perform which of the following functions?
Calcium channel blockers primarily perform which of the following functions?
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What does 'Monday Disease' refer to in the context of nitrate use?
What does 'Monday Disease' refer to in the context of nitrate use?
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What effect do nitrates have on myocardial fiber tension?
What effect do nitrates have on myocardial fiber tension?
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Which of the following symptoms is associated with methemoglobinemia due to nitrate use?
Which of the following symptoms is associated with methemoglobinemia due to nitrate use?
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Which of the following is a therapeutic use of nitrates?
Which of the following is a therapeutic use of nitrates?
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What is the primary effect of nitroglycerin in patients?
What is the primary effect of nitroglycerin in patients?
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Which of the following agents does NOT undergo first pass effect?
Which of the following agents does NOT undergo first pass effect?
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What is a major drug-drug interaction concern with calcium channel blockers (CCBs)?
What is a major drug-drug interaction concern with calcium channel blockers (CCBs)?
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What is the half-life of Isosorbide Dinitrate (ISDN)?
What is the half-life of Isosorbide Dinitrate (ISDN)?
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Which of the following agents is used specifically for the treatment of stable angina pectoris?
Which of the following agents is used specifically for the treatment of stable angina pectoris?
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What effect does amyl nitrite have on the vascular system?
What effect does amyl nitrite have on the vascular system?
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What is a potential side effect of sodium channel blockers?
What is a potential side effect of sodium channel blockers?
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Which drug should be avoided with phosphodiesterase 5 inhibitors due to interactions?
Which drug should be avoided with phosphodiesterase 5 inhibitors due to interactions?
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Which class of drugs is known to improve diastolic function by reducing intracellular sodium?
Which class of drugs is known to improve diastolic function by reducing intracellular sodium?
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Which formulation of nitroglycerin is short acting?
Which formulation of nitroglycerin is short acting?
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What distinguishes unstable angina from other types of angina?
What distinguishes unstable angina from other types of angina?
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Which of the following conditions is most likely to lead to angina?
Which of the following conditions is most likely to lead to angina?
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What is the primary therapeutic strategy for managing angina?
What is the primary therapeutic strategy for managing angina?
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Which type of angina can occur without any physical activity?
Which type of angina can occur without any physical activity?
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What is the main reason for chest pain in stable angina?
What is the main reason for chest pain in stable angina?
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How long can angina typically last during an episode of unstable angina?
How long can angina typically last during an episode of unstable angina?
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What action should be taken if a patient is experiencing angina and is unconscious?
What action should be taken if a patient is experiencing angina and is unconscious?
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What is a common precipitating event for angina episodes?
What is a common precipitating event for angina episodes?
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In which condition are the myocardial cells already dead?
In which condition are the myocardial cells already dead?
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What is the primary mechanism of action for nitrates used in treating angina?
What is the primary mechanism of action for nitrates used in treating angina?
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Study Notes
Angina Pectoris
- A spasmodic, cramp-like choking feeling characterized by severe, sudden, constricting substernal pain often radiating from the pericardium to the left shoulder down to the arm.
- Decreased coronary perfusion due to atherosclerosis.
- Pain can be relieved in 15 minutes of rest and by Nitroglycerin
Types of Angina Pectoris
- Stable angina: Short-lasting, burning, heavy, or squeezing feeling in the chest. Associated with plaques that occlude coronaries.
- Atypical angina: Patients can experience extreme fatigue, nausea or diaphoresis.
- Silent angina: Not associated with any symptoms but there is chest pain.
- Unstable angina (Crescendo angina): Chest pain occurs in increased frequency, duration and intensity. Can be precipitated by progressively less effort. Angina can last longer than 20 minutes. A form of acute coronary syndrome.
- Rest angina (Prinzmetal angina, Variant angina, Vasoprastic angina): Pain can be felt at rest, due to coronary spasm causing decreased blood flow to the heart. Angina attacks are unrelated to physical activities, heart rate, or blood pressure. Responds to vasodilator or CCB.
Therapeutic Strategies
- Increase oxygen delivery (if patient is conscious give water - if unconscious give air)
- Decrease oxygen requirement (rest)
- Increase efficiency of oxygen utilization
Anti-Anginal Drugs
Nitrites/Nitrates
- MOA: Have direct relaxant effect on vascular smooth muscles and dilation of coronary vessels improving oxygen supply to the myocardium.
- Effects: Vasodilation, (-) Inotropy (↓ Cardiac Force), ↓ myocardial fiber tension, ↓ oxygen requirement
- Uses: Relief of acute anginal attacks, Prophylactic treatment, Long term management
- ADR: Headache, Hypotension, Tachycardia, Methemoglobinemia, Monday disease
Beta Blockers
- MOA: Inhibits NE in occupying the receptors, Causes (-) chronotropy (↓ HR), ↓ myocardial fiber tension
- Uses: Prophylaxis of atherosclerotic angina, Prophylaxis of chronic angina together with nitrates
- ADR: Worsen CHF, Bradycardia, Hypotension, Reduced blood flow, Edema
Calcium Channel Blockers
- MOA: Blocks calcium entry into the smooth muscles, causes smooth muscle relaxation (vasodilation), faster blood flow to the myocardium (better delivery of oxygen/ oxygen demand on the body supplied). Causes QT prolongation.
- Uses: Chronic angina, Used in patients who have failed in other anti-anginal drugs
- Agent: Ranolazine
Phosphodiesterase 5 Inhibitors
- Example: Sildenafil (Viagra)
- Can result in synergistic hypotension with nitrates due to vasodilation.
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Description
This quiz covers the definition and types of angina pectoris, including stable, atypical, silent, unstable, and rest angina. You will learn about symptoms, causes, and relief measures such as rest and medication. Test your knowledge on this important cardiovascular condition.
