Podcast
Play an AI-generated podcast conversation about this lesson
Questions and Answers
What is the main symptom of angina pectoris?
What is the main symptom of angina pectoris?
- Back spasms
- Severe head pain
- Leg cramps
- Severe chest pain (correct)
What are the three types of angina pectoris?
What are the three types of angina pectoris?
Stable, unstable, variant
Nitrates cause dilation of __________ arteries to increase oxygen supply.
Nitrates cause dilation of __________ arteries to increase oxygen supply.
coronary
Match the pharmacokinetic factor to the type of nitrate therapy:
Match the pharmacokinetic factor to the type of nitrate therapy:
Signup and view all the answers
What is the main symptom of angina pectoris?
What is the main symptom of angina pectoris?
Signup and view all the answers
Which type of angina has a regular pattern and is the most common?
Which type of angina has a regular pattern and is the most common?
Signup and view all the answers
Angina pectoris results in permanent damage to the heart muscle.
Angina pectoris results in permanent damage to the heart muscle.
Signup and view all the answers
Organic nitrates release ___, responsible for vasodilatation.
Organic nitrates release ___, responsible for vasodilatation.
Signup and view all the answers
Match the following contraindications with the use of nitrates:
Match the following contraindications with the use of nitrates:
Signup and view all the answers
What is the main symptom of angina pectoris?
What is the main symptom of angina pectoris?
Signup and view all the answers
Which type of angina is most common and occurs if the heart is working harder than usual?
Which type of angina is most common and occurs if the heart is working harder than usual?
Signup and view all the answers
Angina pectoris results in permanent damage to the heart muscle.
Angina pectoris results in permanent damage to the heart muscle.
Signup and view all the answers
Nitrates cause dilation of ______ arteries to increase oxygen supply.
Nitrates cause dilation of ______ arteries to increase oxygen supply.
Signup and view all the answers
Match the following nitrate types with their mode of administration:
Match the following nitrate types with their mode of administration:
Signup and view all the answers
Flashcards are hidden until you start studying
Study Notes
Stable Ischemic Heart Disease (SIHD)
- Professor Hany A. Omar's lecture objectives:
- Understand rationale for drug therapy in ischemic heart diseases
- Know classes of drugs used to treat myocardial infarction
- Mode of action of nitrates
- Pharmacokinetics of nitrates and their formulations and delivery methods
- Clinical uses and common side effects of nitrates
- Concept of nitrate tolerance
- Different types of fibrinolytics and their mechanisms of action
Angina Pectoris
- Ischemic myocardial pain resulting from imbalance between oxygen supply and demand
- Main symptoms:
- Severe chest pain due to ischemia of the heart muscle
- Pain extending to shoulders, arms, neck, jaw, or back
- Feeling like pressure or squeezing in the chest
- Types of angina:
- Stable (effort) angina: occurs with physical effort, relieved by rest, and has a regular pattern
- Unstable angina: occurs with increased frequency, precipitated by less effort, and may not be relieved by rest or nitroglycerin
- Variant (Prinzmetal's) angina: rare, occurs due to coronary vasospasm, usually at rest, and relieved by medicine
Differences between Angina Pectoris and Myocardial Infarction
- Angina pectoris: reversible process, no permanent damage to the muscle
- Myocardial infarction: ischemic necrosis due to total occlusion of coronary artery, irreversible changes in muscle
Treatment of Angina Pectoris
- Treatment lines include:
- Vasodilators (increase oxygen supply)
- Agents that decrease oxygen demand (decrease myocardial work)
- Examples:
- Organic nitrates (e.g., Isosorbide dinitrate, Glyceryltrinitrate/Nitroglycerin)
- Mechanism of action: release nitric oxide, which vasodilates blood vessels, increases oxygen supply, and decreases oxygen demand
Nitrates & Nitrites
- Cardiovascular effects:
- Vasodilatation in veins, arteries, and coronaries
- Decrease preload, ventricular filling pressure, cardiac work, and oxygen demand
- Antiplatelet aggregation effect: NO stimulates increase in cGMP in platelets, decreasing platelet aggregation
- Pharmacokinetics:
- Short-acting: sublingual (Nitroglycerin, Isosorbide dinitrate), inhalation (Amyl nitrite)
- Long-acting: oral sustained-release nitrite (Nitroglycerin), transdermal patches (Nitroglycerin), oral (Isosorbide dinitrate)
- Contraindications:
- Hypotension (systolic < 180 or diastolic < 110)
- Recent surgery
- Warfarin therapy
- Active peptic ulcer
- Diabetic retinopathy and history of hypertension
- Ischemic stroke (?)
Fibrinolytic Agents
- Complications:
- Bleeding (most common)
- Intra-cranial hemorrhage (most serious, 0.5-0.7%)
- Liberation of platelets and thrombin from the clot, potentially causing another clot in other sites
- Interactions:
- Aspirin and heparin increase activity and risk of bleeding of fibrinolytics
- Examples:
- Streptokinase: protein produced by streptococci, forms a complex with plasminogen, converting it to plasmin
- Complications and adverse effects:
- Allergic reactions in patients with prior exposure to streptococci
Stable Ischemic Heart Disease (SIHD)
- Professor Hany A. Omar's lecture objectives:
- Understand rationale for drug therapy in ischemic heart diseases
- Know classes of drugs used to treat myocardial infarction
- Mode of action of nitrates
- Pharmacokinetics of nitrates and their formulations and delivery methods
- Clinical uses and common side effects of nitrates
- Concept of nitrate tolerance
- Different types of fibrinolytics and their mechanisms of action
Angina Pectoris
- Ischemic myocardial pain resulting from imbalance between oxygen supply and demand
- Main symptoms:
- Severe chest pain due to ischemia of the heart muscle
- Pain extending to shoulders, arms, neck, jaw, or back
- Feeling like pressure or squeezing in the chest
- Types of angina:
- Stable (effort) angina: occurs with physical effort, relieved by rest, and has a regular pattern
- Unstable angina: occurs with increased frequency, precipitated by less effort, and may not be relieved by rest or nitroglycerin
- Variant (Prinzmetal's) angina: rare, occurs due to coronary vasospasm, usually at rest, and relieved by medicine
Differences between Angina Pectoris and Myocardial Infarction
- Angina pectoris: reversible process, no permanent damage to the muscle
- Myocardial infarction: ischemic necrosis due to total occlusion of coronary artery, irreversible changes in muscle
Treatment of Angina Pectoris
- Treatment lines include:
- Vasodilators (increase oxygen supply)
- Agents that decrease oxygen demand (decrease myocardial work)
- Examples:
- Organic nitrates (e.g., Isosorbide dinitrate, Glyceryltrinitrate/Nitroglycerin)
- Mechanism of action: release nitric oxide, which vasodilates blood vessels, increases oxygen supply, and decreases oxygen demand
Nitrates & Nitrites
- Cardiovascular effects:
- Vasodilatation in veins, arteries, and coronaries
- Decrease preload, ventricular filling pressure, cardiac work, and oxygen demand
- Antiplatelet aggregation effect: NO stimulates increase in cGMP in platelets, decreasing platelet aggregation
- Pharmacokinetics:
- Short-acting: sublingual (Nitroglycerin, Isosorbide dinitrate), inhalation (Amyl nitrite)
- Long-acting: oral sustained-release nitrite (Nitroglycerin), transdermal patches (Nitroglycerin), oral (Isosorbide dinitrate)
- Contraindications:
- Hypotension (systolic < 180 or diastolic < 110)
- Recent surgery
- Warfarin therapy
- Active peptic ulcer
- Diabetic retinopathy and history of hypertension
- Ischemic stroke (?)
Fibrinolytic Agents
- Complications:
- Bleeding (most common)
- Intra-cranial hemorrhage (most serious, 0.5-0.7%)
- Liberation of platelets and thrombin from the clot, potentially causing another clot in other sites
- Interactions:
- Aspirin and heparin increase activity and risk of bleeding of fibrinolytics
- Examples:
- Streptokinase: protein produced by streptococci, forms a complex with plasminogen, converting it to plasmin
- Complications and adverse effects:
- Allergic reactions in patients with prior exposure to streptococci
Stable Ischemic Heart Disease (SIHD)
- Professor Hany A. Omar's lecture objectives:
- Understand rationale for drug therapy in ischemic heart diseases
- Know classes of drugs used to treat myocardial infarction
- Mode of action of nitrates
- Pharmacokinetics of nitrates and their formulations and delivery methods
- Clinical uses and common side effects of nitrates
- Concept of nitrate tolerance
- Different types of fibrinolytics and their mechanisms of action
Angina Pectoris
- Ischemic myocardial pain resulting from imbalance between oxygen supply and demand
- Main symptoms:
- Severe chest pain due to ischemia of the heart muscle
- Pain extending to shoulders, arms, neck, jaw, or back
- Feeling like pressure or squeezing in the chest
- Types of angina:
- Stable (effort) angina: occurs with physical effort, relieved by rest, and has a regular pattern
- Unstable angina: occurs with increased frequency, precipitated by less effort, and may not be relieved by rest or nitroglycerin
- Variant (Prinzmetal's) angina: rare, occurs due to coronary vasospasm, usually at rest, and relieved by medicine
Differences between Angina Pectoris and Myocardial Infarction
- Angina pectoris: reversible process, no permanent damage to the muscle
- Myocardial infarction: ischemic necrosis due to total occlusion of coronary artery, irreversible changes in muscle
Treatment of Angina Pectoris
- Treatment lines include:
- Vasodilators (increase oxygen supply)
- Agents that decrease oxygen demand (decrease myocardial work)
- Examples:
- Organic nitrates (e.g., Isosorbide dinitrate, Glyceryltrinitrate/Nitroglycerin)
- Mechanism of action: release nitric oxide, which vasodilates blood vessels, increases oxygen supply, and decreases oxygen demand
Nitrates & Nitrites
- Cardiovascular effects:
- Vasodilatation in veins, arteries, and coronaries
- Decrease preload, ventricular filling pressure, cardiac work, and oxygen demand
- Antiplatelet aggregation effect: NO stimulates increase in cGMP in platelets, decreasing platelet aggregation
- Pharmacokinetics:
- Short-acting: sublingual (Nitroglycerin, Isosorbide dinitrate), inhalation (Amyl nitrite)
- Long-acting: oral sustained-release nitrite (Nitroglycerin), transdermal patches (Nitroglycerin), oral (Isosorbide dinitrate)
- Contraindications:
- Hypotension (systolic < 180 or diastolic < 110)
- Recent surgery
- Warfarin therapy
- Active peptic ulcer
- Diabetic retinopathy and history of hypertension
- Ischemic stroke (?)
Fibrinolytic Agents
- Complications:
- Bleeding (most common)
- Intra-cranial hemorrhage (most serious, 0.5-0.7%)
- Liberation of platelets and thrombin from the clot, potentially causing another clot in other sites
- Interactions:
- Aspirin and heparin increase activity and risk of bleeding of fibrinolytics
- Examples:
- Streptokinase: protein produced by streptococci, forms a complex with plasminogen, converting it to plasmin
- Complications and adverse effects:
- Allergic reactions in patients with prior exposure to streptococci
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
