Pharmacology Chapter 17: Angina Treatment
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Questions and Answers

What is a common mechanism of action for nitrates used in the treatment of angina?

  • They increase heart rate and workload.
  • They suppress heart muscle contraction.
  • They dilate blood vessels and increase oxygen supply to the heart. (correct)
  • They block beta-receptor sites.

Which drug class is used primarily to reduce the heart's demand for oxygen?

  • Anticoagulants
  • Calcium Channel Blockers
  • Beta-Adrenergic Blockers (correct)
  • Nitrates

Which of the following is a potential adverse reaction associated with nitrates?

  • Constipation
  • Bradycardia
  • Heart block
  • Hypotension (correct)

Identify the LOOK-ALIKE/SOUND-ALIKE issue with beta-adrenergic blockers.

<p>Atenolol and albuterol (B)</p> Signup and view all the answers

What common ending is associated with dihydropyridine calcium channel blockers?

<p>-dipine (C)</p> Signup and view all the answers

Which of the following is NOT a recognized type of angina?

<p>Chronic angina (A)</p> Signup and view all the answers

Which precaution is specifically noted for calcium channel blockers?

<p>Limit caffeine and alcohol. (C)</p> Signup and view all the answers

Which medication is a long-acting metabolite used for the prevention of angina?

<p>Isosorbide mononitrate (B)</p> Signup and view all the answers

What type of adverse reaction is most commonly associated with beta-adrenergic blockers?

<p>Dizziness (D)</p> Signup and view all the answers

Which group of drugs is commonly confused with nitrates due to similar names?

<p>Beta-Adrenergic Blockers (C)</p> Signup and view all the answers

Which of the following is a common symptom of angina?

<p>Severe squeezing or pressurelike chest pain (C)</p> Signup and view all the answers

What lifestyle change can help reduce the risk of angina?

<p>Engaging in regular exercise (C)</p> Signup and view all the answers

What does unstable angina refer to?

<p>Angina that occurs without exertion (A)</p> Signup and view all the answers

Which factor contributes to coronary artery disease?

<p>High dietary cholesterol (C)</p> Signup and view all the answers

What type of angina is caused by vasospasm of coronary arteries?

<p>Variant or vasospastic angina (B)</p> Signup and view all the answers

Which of the following is NOT considered a risk factor for angina?

<p>High exercise frequency (A)</p> Signup and view all the answers

How can stress management benefit individuals at risk for angina?

<p>It reduces the frequency of angina symptoms (B)</p> Signup and view all the answers

What happens during atherosclerosis in relation to angina?

<p>Lipid streaks harden into plaques which may reduce blood flow (C)</p> Signup and view all the answers

What is a recommended dietary change for preventing angina?

<p>Reducing high cholesterol foods (B)</p> Signup and view all the answers

Which activity is most likely to trigger stable angina?

<p>Intense physical exertion (B)</p> Signup and view all the answers

What is angina pectoris characterized by?

<p>Severe squeezing or pressure-like chest pain (A)</p> Signup and view all the answers

Which of the following is a risk factor for angina?

<p>Hyperlipidemia (A)</p> Signup and view all the answers

How does coronary artery disease contribute to angina?

<p>By narrowing and hardening the arteries supplying blood to the heart (A)</p> Signup and view all the answers

What condition is often caused by the occlusion of a coronary artery?

<p>Myocardial infarction (B)</p> Signup and view all the answers

What does ischemia refer to?

<p>Deficient blood supply to a part of the body (C)</p> Signup and view all the answers

Which term describes the condition of hardening and narrowing of arteries?

<p>Atherosclerosis (A)</p> Signup and view all the answers

What effect does vasospasm have on blood vessels?

<p>Constricts blood vessels and reduces blood flow (D)</p> Signup and view all the answers

Which of the following is NOT a symptom of angina?

<p>Elevated heart rate (C)</p> Signup and view all the answers

What is atheromas?

<p>Fatty deposits within arteries (A)</p> Signup and view all the answers

What is the primary role of aldosterone in the body?

<p>Promotes sodium and fluid reabsorption (D)</p> Signup and view all the answers

Which of the following describes isolated systolic hypertension?

<p>Systolic blood pressure is elevated while diastolic is normal (C)</p> Signup and view all the answers

What does the renin-aldosterone-angiotensin system primarily regulate?

<p>Blood volume and blood pressure (D)</p> Signup and view all the answers

Which lifestyle change is most effective in reducing the risk of hypertension?

<p>Regular physical activity (B)</p> Signup and view all the answers

What complication is associated with untreated or poorly controlled hypertension?

<p>Increased risk of stroke (D)</p> Signup and view all the answers

Which factor is vital in the development of coronary heart disease that can contribute to hypertension?

<p>Atherosclerosis (D)</p> Signup and view all the answers

What is the formula for determining blood pressure?

<p>BP = CO × PR (A)</p> Signup and view all the answers

What measurement defines diastolic blood pressure?

<p>Pressure during heart rest phase (A)</p> Signup and view all the answers

What condition is characterized by sudden drops in blood pressure upon standing?

<p>Orthostatic hypotension (B)</p> Signup and view all the answers

Which of the following is a regulatory site for blood pressure control?

<p>Kidneys (D)</p> Signup and view all the answers

Which condition is NOT considered a risk factor for hypertension?

<p>Increased HDL (C)</p> Signup and view all the answers

What does hyperkalemia refer to?

<p>Elevated potassium levels in the blood (A)</p> Signup and view all the answers

What is a significant risk factor for hypertension related to metabolic health?

<p>Being overweight or obese (B)</p> Signup and view all the answers

Which drug is known to increase blood pressure as a side effect?

<p>Ibuprofen (C)</p> Signup and view all the answers

What is considered stage 1 hypertension?

<p>140-149 / 90-99 mmHg (C)</p> Signup and view all the answers

Which lifestyle factor contributes to hypertension?

<p>Excessive alcohol consumption (B)</p> Signup and view all the answers

What is a potential consequence of metabolic syndrome?

<p>Atherosclerosis (C)</p> Signup and view all the answers

Which option is NOT a known effect of increased peripheral resistance?

<p>Improved cardiac output (C)</p> Signup and view all the answers

What is the relationship between obesity and blood pressure?

<p>Obesity can increase blood pressure (D)</p> Signup and view all the answers

Which of the following drugs is specifically associated with increasing blood pressure?

<p>Oral contraceptives (D)</p> Signup and view all the answers

Flashcards

Angina Pectoris

A symptom of ischemic heart disease, characterized by chest pain triggered by exertion or stress.

Arteriosclerosis

Thickening and loss of elasticity in arterial walls.

Atheroma

Hard plaque formed within an artery.

Atherosclerosis

Plaques (atheromas) form in arteries due to cholesterol and fat.

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Coronary Artery Disease

Hardening and narrowing of arteries supplying blood to the heart.

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Embolus

A moving blood clot.

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Hyperlipidemia

High levels of cholesterol and triglycerides in the blood.

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Ischemia

Low blood supply to a body part.

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Myocardial Infarction

Heart attack; death of heart muscle tissue.

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Thrombus

A stationary blood clot.

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Angina Risk Factors

Conditions like heart disease, hypertension, diabetes, obesity, and stress, as well as lifestyle choices like smoking and diet, increase the risk of angina.

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Angina Symptoms

Angina causes severe squeezing or pressure-like chest pain, often radiating to arms, shoulders, neck, or jaw. It may feel like severe heartburn or indigestion.

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Angina Cause

Angina happens when the heart muscle doesn't get enough blood and oxygen due to an imbalance between the blood supply and demand.

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Stable Angina

Stable angina is chest pain triggered by physical exertion, stress, or other factors. Pain goes away with rest.

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Unstable Angina

Unstable angina is chest pain that occurs unexpectedly, even at rest, and suggests a severe problem.

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Vasospastic Angina

Vasospastic angina is chest pain caused by spasms in the coronary arteries.

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Angina Non-Pharmacological Treatment

Non-medication treatment of angina includes lifestyle changes like rest, avoiding high-salt/high-cholesterol foods, stress management, and promoting healthier options at work or in the community.

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High Cholesterol Diet

Diets high in cholesterol contribute to the buildup of cholesterol within arteries, causing blockages that lead to angina.

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Nitrates for Angina

Drugs that dilate blood vessels and increase oxygen supply to the heart, often used in acute or preventative treatment of angina.

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Nitrate Mechanism

Nitrates are prodrugs converted to nitrous oxide in the body, causing blood vessel relaxation, which improves blood flow to the heart.

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Nitrate Side Effects

Low blood pressure, flushing, dizziness, headache, nausea, vomiting, weakness, and fatigue.

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Nitrate Look-Alikes

Drugs that have similar names (e.g., Isordil, Isuprel, Nitro Bid) that can cause confusion.

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Beta-Blockers for Angina

Drugs that reduce the heart's workload by blocking sympathetic nervous system signals. Used to treat stable angina.

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Beta-Blocker Mechanism

Bind to beta receptors, blocking the sympathetic nervous system, decreasing heart rate and workload to treat exertional angina.

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Beta-Blocker Side Effects

Dizziness, fatigue, slow heart rate, low blood pressure, impotence, and heart block.

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Calcium Channel Blocker Types

Dihydropyridines (like amlodipine) and nondihydropyridines (like diltiazem) are two main classifications.

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Calcium Channel Blocker Mechanism

Block calcium channels affecting heart muscle contraction and blood vessel dilation, thus reducing angina symptoms.

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Important Drug Warnings

Always follow your doctor's instructions and be careful about drug interactions. Don't take medications that look or sound alike.

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Hypertension

High blood pressure, defined as elevated systolic or diastolic blood pressure, or both.

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Systolic Blood Pressure

The pressure in your arteries when your heart beats (contracts) and pumps blood.

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Diastolic Blood Pressure

The pressure in your arteries when your heart is at rest between beats.

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Renin-Aldosterone-Angiotensin System (RAAS)

A complex system in your body that regulates blood pressure by controlling fluid balance and blood vessel constriction.

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Angiotensin II

A powerful chemical in your body that causes blood vessels to narrow and blood pressure to rise.

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Diuretic

Medication that helps you remove excess fluid from your body through urine, which can lower blood pressure.

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Cardiac Output

The amount of blood your heart pumps in one minute.

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Orthostatic Hypotension

A sudden drop in blood pressure that occurs when standing up from lying down or sitting.

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Peripheral Vascular Resistance

The resistance to blood flow in your smaller blood vessels.

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Metabolic Syndrome

A group of conditions that increase your risk for heart disease, stroke, and type 2 diabetes.

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Blood Pressure Formula

Blood Pressure (BP) is calculated by multiplying Cardiac Output (CO) and Peripheral Resistance (PR). This means higher heart pumping force or narrower blood vessels lead to higher BP.

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Blood Pressure Control

Multiple body systems regulate BP, including the kidneys, heart, blood vessels, central nervous system, and sympathetic nerves.

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Hypertension and Metabolic Syndrome

Metabolic syndrome, a cluster of risk factors like obesity and high blood sugar, can contribute to hypertension and lead to serious conditions like atherosclerosis and cardiovascular disease.

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Drugs that Increase Blood Pressure

Certain medications, like NSAIDs and stimulants, can raise BP. Be aware of these potential effects if taking these drugs.

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Hypertension Risk Factors

Age, diabetes, family history, obesity, smoking, lack of exercise, high LDL cholesterol, high salt diet, and excessive alcohol consumption can increase your risk of high blood pressure.

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Stage 1 Hypertension

A blood pressure reading that falls within the range of mild high blood pressure. Medical management is usually recommended.

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Stage 2 Hypertension

A blood pressure reading that falls within the range of severe high blood pressure, requiring aggressive treatment to prevent complications.

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White Coat Hypertension

Elevated blood pressure readings only during doctor visits, likely due to anxiety. It doesn't usually require treatment unless consistently high outside the doctor's office.

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Preeclampsia and Gestational Hypertension

High blood pressure specifically during pregnancy, potentially dangerous for mother and baby.

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Study Notes

Pharmacology for Pharmacy Technicians, 4th Edition

  • This book is by Kathy Moscou PhD RPh MPH and Karen Snipe CPhT AS BA MEd
  • Copyright is held by Elsevier Inc.

Chapter 17: Treatment of Angina

  • The chapter focuses on the treatment of angina
  • Covers terminology, symptoms, risk factors, coronary artery disease role, and lifestyle changes for reducing angina risk.

Lesson 17.1: Angina

  • Learn the terminology related to angina treatment.
  • List symptoms and risk factors for angina.
  • Explain coronary artery disease's role in angina development.
  • Identify lifestyle changes that lower angina risk.

Key Terms

  • Angina pectoris: Severe chest pain due to ischemic heart disease triggered by exertion or stress.
  • Arteriosclerosis: Hardening and thickening of arterial walls, losing elasticity.
  • Atheroma: Hard plaque buildup inside an artery.
  • Atherosclerosis: Plaque buildup in arteries, narrowing them.
  • Coronary artery disease: Hardening and narrowing of the arteries supplying blood to the heart.
  • Embolus: Moving blood clot.
  • Hyperlipidemia: High cholesterol and triglycerides in the blood.
  • Ischemia: Insufficient blood supply to an area of the body.
  • Ischemic heart disease: Heart muscle damage/inefficient function due to inadequate blood supply.
  • Necrosis: Cell death, often from lack of blood/oxygen.
  • Myocardial infarction: Heart attack; heart muscle death due to blockage (occlusion) of a coronary artery.
  • Thrombus: Stationary blood clot.
  • Vasospasm: Spasms constricting blood vessels, reducing blood & oxygen flow.

Overview of Angina (1 of 2)

  • Risk factors: Heart disease, hypertension, diabetes, obesity, and stress.

Overview of Angina (2 of 2)

  • Risk factors (lifestyle): Smoking, overeating, high-cholesterol/salt diets, excessive alcohol use, and lack of exercise.

Angina (1 of 3)

  • Chest pain (squeezing or pressure-like)
  • Pain radiating to arms, shoulders, neck, or jaw
  • Described as severe heartburn or indigestion.

Angina (2 of 3)

  • Imbalance between blood supply to heart muscle and oxygen need.
  • Symptoms occur when heart's oxygen supply is insufficient.

Angina (3 of 3)

  • Coronary artery disease: High dietary cholesterol contributes.
  • Cholesterol, lipids, and lipophages build up in arteries.
  • Atherosclerosis: Lipid streaks harden into plaques (atheromas), reducing blood flow.

Types of Angina

  • Stable angina: Symptoms during exertion (physical activity, smoking, eating, stress), often relieved by rest.
  • Unstable angina: Symptoms without exertion or occurs when an embolus (blood clot).
  • Variant or vasospastic angina: Symptoms caused by coronary artery vasospasm (narrowing) at rest, during the night, or early morning.

Nonpharmacological Treatment of Angina

  • Lifestyle changes: Rest breaks to avoid angina, avoid high-salt/cholesterol foods, portion control, stress management techniques, and health changes for better workplace and community lifestyle—nutritious choices in cafeterias.

Lesson 17.2: Drugs Used to Treat Angina

  • List and categorize medications for angina treatment.
  • Detail the mechanism of action for each drug class.
  • Identify look-alike/sound-alike drug issues.
  • List common endings for drug classes in angina treatment.
  • Explain warning labels and precautions for angina medications.

Drugs Used in the Treatment of Angina

  • Nitrates: Isosorbide dinitrate (acute and extended-release), Isosorbide mononitrate (long-acting metabolite, used for prevention only) and Nitroglycerin (acute and extended-release).

Nitrates (1 of 2)

  • Dilate blood vessels (arteries and veins)
  • Increase oxygen supply to the heart.
  • Pro-drugs that convert to nitrous oxide in the body causing vascular relaxation.

Nitrates (2 of 2)

  • Adverse Reactions: Vasodilation, hypotension, facial flushing, dizziness, headache, nausea, vomiting, and fatigue.

Look-Alike/Sound-Alike Drugs: Nitrates

  • Isordil, Isuprel, Inderal; Imdur, Imuran; Monoket, Monopril; Nitro Bid, Nicobid; Nitroderm, Nicoderm; Nitrol, Nizoral; Nitrostat, Nilstat, Hyperstat.

Beta-Adrenergic Blockers (1 of 3)

  • Atenolol, Metoprolol, Nadolol, Propranolol.

Beta-Adrenergic Blockers (2 of 3)

  • Reduce heart's oxygen demand by binding to beta-receptor sites and blocking sympathetic nervous system activity, decreasing heart rate and workload.
  • Decrease frequency and severity of stable (exertional) angina.

Beta-Adrenergic Blockers (3 of 3)

  • Adverse Reactions: Dizziness, fatigue, bradycardia, hypotension, and heart block.

Look-Alike/Sound-Alike Drugs: Beta-Adrenergic Blockers

  • Atenolol, albuterol, timolol; Tenormin, Norpramin, thiamine; Metoprolol, metolazone, metaproterenol, misoprostol; Toprol-XL, Topamax; Corgard, Coreg, Cognex; Inderal, Isordil, Toradol, Imdur, Adderall, Enduron, Enduronyl, Inderal LA, Inderide.

Calcium Channel Blockers (1 of 3)

  • Dihydropyridines: Amlodipine, Nicardipine, Nifedipine
  • Nondihydropyridines: Benzothiazepines (diltiazem), Phenylalkylamines (verapamil).

Calcium Channel Blockers (2 of 3)

  • Block L-type voltage-dependent calcium channels, suppressing depolarization, and reducing heart muscle contraction.
  • Dihydropyridines are selective for blood vessels, do not slow heart rate.

Calcium Channel Blockers (3 of 3)

  • Adverse reactions (Dihydropyridines): Dizziness, flushing, headache, peripheral edema
  • Adverse reactions (Nondihydropyridines): Heart block, heart failure, bradycardia, and constipation.

Look-Alike/Sound-Alike Drugs: Calcium Channel Blockers

  • Norvasc, Norvir, Vasocor; Amlodipine, Amiloride; Cardizem, Cardura, Cardene, Cardizem SR, Cardene SR, Cardizem CD; Tiazac, Tigan, Ziac; Nicardipine, nifedipine, nimodipine; Procardia, Procardia XL, Cartia XT; Covera HS, Provera; Verelan, verapamil, Voltaren.

Tech Note: Common Syllables and Endings

  • Nitrates use "nitro," "nitra" in brand/generic names
  • Beta-blockers end in "-olol"
  • Dihydropyridine calcium channel blockers end in "-dipine".

Other Drug Classifications

  • Angiotensin-converting enzyme inhibitors (ACEIs)
  • Anticoagulants
  • Antiplatelet drugs
  • Glycoprotein IIb/IIIa drugs
  • Antihyperlipidemics

Warning Labels

  • Nitrates: Take on empty stomach (isosorbide dinitrate), swallow whole (sustained/extended-release), avoid alcohol.
  • Beta-adrenergic blockers: May cause dizziness, use caution when driving or performing alert tasks, avoid abrupt discontinuation.
  • Calcium channel blockers: May cause dizziness, limit caffeine and alcohol.

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Pharmacology for Pharmacy Technicians, 4th Edition PDF
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Description

Explore Chapter 17 of 'Pharmacology for Pharmacy Technicians', focusing on the treatment of angina. Understand the key terms, symptoms, risk factors, and the role of coronary artery disease in angina. Learn about lifestyle changes that can reduce angina risk effectively.

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