16 Questions
What is the main cause of stable angina?
Reduced blood supply due to atherosclerotic changes in coronary arteries
What is the typical characteristic of anginal pain?
Transient and subsides with rest
What is the aim of treatment for stable angina?
Reducing myocardial oxygen demand, increasing oxygen delivery, and preventing plaque progression and thrombotic complications
Which medication is commonly used for prophylactic treatment of stable angina?
Isosorbide mononitrate
Which medication is used in acute treatment of coronary artery disease and MI?
Alteplase
What is the potential consequence of too frequent use of organic nitrates?
Tolerance
Which adverse drug reaction may occur with organic nitrates?
Dizziness
Why may drugs with first-pass metabolism need larger doses if administered orally?
Inactivation in that form
What is the mechanism of action of calcium channel blockers (CCBs) like amlodipine and verapamil?
Blocking calcium entry into the cell
What are the adverse drug reactions associated with calcium channel blockers (CCBs)?
Hypotension
How do beta blockers like propranolol and atenolol affect the heart?
Reduce heart rate and contractility
What adverse drug reaction may occur with beta blockers?
Bradycardia
Why should beta blockers be taken regularly and not for acute attacks?
Abrupt withdrawal may be dangerous
What is a contraindication for beta blockers?
Asthma
Which medication should not be used with PDE5 inhibitors due to the potential for severe hypotension and cardiovascular collapse?
Organic nitrates
What is the potential consequence of too frequent use of organic nitrates?
Tolerance
Study Notes
Cardiovascular Pharmacotherapy Overview
- Plasminogen activators, including alteplase, reteplase, and tenecteplase, convert plasminogen to plasmin, which breaks down fibrin, and are used in acute treatment of coronary artery disease and MI.
- Organic nitrates like glyceryl trinitrate and isosorbide mononitrate are used in both acute and prophylactic treatment of stable angina to increase cGMP levels, producing smooth muscle relaxation and vasodilation.
- Tolerance to organic nitrates can occur with too frequent use, leading to reduced therapeutic effect.
- Adverse drug reactions to organic nitrates may include dizziness, postural hypotension, and headache, with potential drug interactions with PDE5 inhibitors.
- Drugs with first-pass metabolism, like glyceryl trinitrate, need larger doses if administered orally and may be inactive in that form.
- Organic nitrates should not be used with PDE5 inhibitors due to the potential for severe hypotension and cardiovascular collapse.
- Calcium channel blockers (CCBs) like amlodipine and verapamil bind to the alpha1 subunit of the VGCC L-type, blocking calcium entry into the cell and producing vasodilation, reducing peripheral resistance and afterload.
- CCBs are used for prophylactic treatment of angina and may cause hypotension, headaches, and peripheral edema as adverse drug reactions.
- Beta blockers like propranolol and atenolol reduce the effects of the sympathetic nervous system on the heart, reducing heart rate, contractility, and cardiac work, and are used to treat angina, hypertension, and other conditions.
- Adverse drug reactions to beta blockers may include wheezing, bradycardia, fatigue, and sleep disturbances, with potential drug interactions.
- Beta blockers should be taken regularly and not for acute attacks, and abrupt withdrawal may be dangerous, resulting in severe angina, arrhythmias, MI, and rebound hypertension.
- Beta blockers are contraindicated in patients with asthma and may impact diabetes management.
Test your knowledge of cardiovascular pharmacotherapy with this quiz. Explore the uses, mechanisms, and adverse reactions of drugs like plasminogen activators, organic nitrates, calcium channel blockers, and beta blockers in the treatment of coronary artery disease, stable angina, and hypertension.
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