Drugs for Coronary Artery Disease and Angina

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is a common neurological effect associated with the disturbances mentioned?

Dizziness

Confusion (correct)

Memory loss

Tinnitus

How do potassium and digoxin interact within the body?

They have no interaction.

They compete for the same binding site. (correct)

They lower blood pressure together.

They enhance each other's activity.

What effect does digoxin have on potassium levels?

It has no effect on potassium levels.

It decreases potassium levels. (correct)

It transforms potassium into sodium.

It increases potassium levels.

Which antibiotic is mentioned as interacting with digoxin?

Erythromycin Signup and view all the answers

What symptoms may arise from disturbances of vision as stated in the content?

Fatigue and muscle weakness Signup and view all the answers

What is the primary effect of the relaxation of large capacitance veins?

Increased venous blood returning to the heart Signup and view all the answers

How does vasodilation affect cardiac output?

It decreases cardiac output due to lower venous return Signup and view all the answers

What can be a result of an increase in venous blood returning to the heart?

Increased oxygen demand of the heart Signup and view all the answers

What physiological change occurs as a result of large capacitance veins undergoing relaxation?

Decreased pressure in the veins Signup and view all the answers

What is a consequence of decreased cardiac output?

Reduced blood pressure Signup and view all the answers

What role do large capacitance veins play in the circulatory system?

They store blood for future use Signup and view all the answers

What could potentially lead to reduced oxygen demand by the heart?

Decreased blood pressure Signup and view all the answers

Which of the following statements is true regarding vasodilation?

It is associated with decreased resistance in blood vessels Signup and view all the answers

What is the primary goal of non-pharmacological treatment in heart failure?

To reduce symptoms and slow progression Signup and view all the answers

Which dietary modification is recommended for managing heart failure?

Implement salt restriction Signup and view all the answers

What type of surgery may be indicated for heart failure management?

Coronary revascularization Signup and view all the answers

Which class of medication is used as a first-line treatment for heart failure?

Diuretics Signup and view all the answers

What is the effect of vasodilators in heart failure treatment?

Decrease blood pressure Signup and view all the answers

What is a primary effect of diuretics on heart failure patients?

Expulsion of salt and water Signup and view all the answers

Which medication class is considered as second-line treatment for heart failure?

Inhibitors of RAS Signup and view all the answers

How does physical activity contribute to heart failure management?

It can help improve overall health Signup and view all the answers

What is the role of positive inotropic agents in heart failure treatment?

To strengthen heart contractions Signup and view all the answers

What is a common misconception about the diet of heart failure patients?

High-calorie diets are recommended Signup and view all the answers

What is a consequence of prolonged activation of B receptors in the heart?

Increased levels of angiotensin II Signup and view all the answers

How does activation of the renin-angiotensin system affect cardiovascular health?

It causes inflammation and remodeling in the heart and blood vessels. Signup and view all the answers

What results from cardiac cell death?

Increased stress on the heart Signup and view all the answers

What compensatory mechanism occurs in the heart during heart failure?

Hypertrophy of heart muscle mass Signup and view all the answers

Which of the following is not a factor leading to heart failure?

Increased antagonism of angiotensin II Signup and view all the answers

What role do caspases play in heart failure?

They are involved in apoptosis and inflammation. Signup and view all the answers

What is the primary goal of heart failure treatment?

To maintain or improve cardiac output Signup and view all the answers

Why is long-term hypertrophy of the heart detrimental?

It contributes to worsening heart failure. Signup and view all the answers

Which condition can result from the activation of the sympathetic nervous system (SNS) in heart failure?

Increased caspase activity. Signup and view all the answers

What is one way the heart attempts to compensate for reduced function in heart failure?

By increasing muscle mass. Signup and view all the answers

What is the primary effect of propranolol in treating typical angina?

It reduces heart rate and myocardial contractility. Signup and view all the answers

Which type of angina is typically treated with beta blockers?

Typical angina Signup and view all the answers

Calcium channel blockers primarily act by which mechanism?

Blocking calcium entry into cells Signup and view all the answers

What physiological change is caused by calcium channel blockers in the context of angina treatment?

Decreased workload on the heart Signup and view all the answers

Which of the following is a common adverse effect of calcium channel blockers?

Hypotension Signup and view all the answers

Why are beta blockers often avoided in variant angina?

They can worsen coronary vasospasm. Signup and view all the answers

What is a key benefit of using calcium channel blockers in angina management?

They preferentially dilate coronary arteries. Signup and view all the answers

Which statement about the mechanism of action of beta blockers is accurate?

They inhibit sympathetic nervous system activation. Signup and view all the answers

In the context of angina treatment, what effect does the relaxation of arterioles have?

It results in reduced workload on the heart. Signup and view all the answers

Which adverse effect is least likely associated with calcium channel blockers?

Hypoglycemia Signup and view all the answers

What is a major drawback of using beta blockers for angina treatment?

They may cause respiratory issues. Signup and view all the answers

Which of the following is true regarding the use of calcium channel blockers and angina?

They are preferred for variant angina prophylaxis. Signup and view all the answers

Which of the following physiological responses does propranolol facilitate in angina treatment?

Decreased activity of the sympathetic nervous system. Signup and view all the answers

What is the primary mechanism of action of digoxin?

It inhibits sodium-potassium ATPase, leading to sodium accumulation. Signup and view all the answers

Which condition is NOT commonly treated with digoxin?

Hypotension Signup and view all the answers

What percentage of patients with normal heart rhythm will experience relief from heart failure symptoms using digoxin?

50% Signup and view all the answers

What is a common early sign of digoxin toxicity?

Diarrhea Signup and view all the answers

Why must blood levels of digoxin be monitored closely?

It has a narrow therapeutic index. Signup and view all the answers

What effect does digoxin have on electrical impulses in the heart?

It decreases the conduction velocity in the AV node. Signup and view all the answers

Which of the following is a potential consequence of digoxin usage?

Cardiac arrhythmias Signup and view all the answers

How does digoxin affect myocardial contractility?

It increases myocardial contractility. Signup and view all the answers

What is a reason digoxin is considered a 2nd line treatment?

It is typically used only when first-line agents fail. Signup and view all the answers

Digoxin acts by inhibiting which enzyme?

Sodium-potassium ATPase Signup and view all the answers

In patients with atrial fibrillation, what effect does digoxin have?

It decreases the number of impulses from the atria to the ventricles. Signup and view all the answers

How does digoxin affect calcium levels in cardiac cells?

It increases intracellular calcium levels. Signup and view all the answers

What is a common laboratory measure to monitor while a patient is on digoxin?

Electrolyte levels. Signup and view all the answers

What factor increases the likelihood of digoxin toxicity in patients?

Decreased renal function. Signup and view all the answers

What is a therapeutic benefit of digoxin in patients with atrial fibrillation?

It provides symptomatic relief by slowing the heart rate. Signup and view all the answers

Study Notes

Drugs for Coronary Artery Disease and Heart Failure

Coronary Artery Disease (CAD): Characterized by narrowing of coronary arteries, reducing blood flow to the heart
Angina Pectoris (chest pain): Pain from reduced blood flow.
Causes of Angina: Narrowing of coronary arteries due to atherosclerosis (fatty buildup)
Factors increasing Heart Demand: Exercise, excitement, eating, cold exposure
Types of Angina:
- Typical Angina: Chest pain during exertion (exercise) often due to plaque buildup
- Variant Angina: Chest pain during rest, often due to vasospasm (unobstructed coronary arteries)

Drugs for Angina

Organic Nitrates (e.g., nitroglycerin):
- Two main mechanisms of action: relaxation of large capacitance veins (decreasing venous return to the heart), and dilation of coronary arteries (increasing blood supply to the heart)
- Used to terminate acute angina attacks
- Can also be used for prevention of angina attacks through prophylaxis.
Beta Blockers (e.g., propranolol):
- Decrease heart rate and contractility, which lowers oxygen demand on the heart.
- Used for long-term prevention of angina.
Calcium Channel Blockers (e.g., nifedipine):
- Relax coronary arteries, decreasing workload on the heart.
- Used for both typical and variant angina.
Adverse effects:
- Headaches, flushing, hypotension, tachycardia, dizziness (Organic Nitrates).

Heart Failure

Mechanisms of Heart Failure:
- Prolonged activation of the sympathetic nervous system (SNS): increasing heart rate and contractile force
- Activation of the renin-angiotensin-aldosterone system (RAAS): leading to fluid retention and vasoconstriction
- Cardiac remodeling: structural changes in the heart due to stress and strain.
Goals of Heart Failure Treatment:
- Slow the progression of the disease
- Reduce symptoms
- Manage acute episodes of decompensated failure
Non-Pharmacological Treatment:
- Increase physical activity
- Dietary control (e.g., reduce salt intake)
Pharmacological Treatment:
- Diuretics: Increase urine output to reduce fluid overload
- Vasodilators: widen blood vessels to reduce workload on the heart
- Positive Inotropic Agents: Improve heart contractility (e.g., digoxin)
Drug-Drug Interactions: - Antibiotics (e.g., erythromycin) may interfere with digoxin metabolism, potentially leading to increased digoxin levels.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz covers essential information regarding coronary artery disease and heart failure, focusing specifically on angina types and their causes. It explains the various drugs used to manage angina, particularly organic nitrates and their mechanisms of action. Test your understanding of these critical cardiovascular topics.