Pharmacology of Cardiac Contractility and Angina

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Questions and Answers

Beta blockers are primarily used for the treatment of angina pectoris.

True

What is the primary action of bipyridine derivatives like Amrinone and Milrinone?

Increase heart rate

Lower blood pressure

Act as anticoagulants

Promote vasodilatation and positive inotropic effects (correct)

What is a common side effect of bipyridine derivatives?

Thrombocytopenia

Organic nitrates are esters of alcohols with __________.

nitric acid Signup and view all the answers

Match the drug class with its mechanism of action:

Beta Blockers = Reduce heart rate and workload Calcium Channel Blockers = Inhibit calcium entry to muscles Organic Nitrates = Relax blood vessels Vasodilators = Widen blood vessels to increase blood flow Signup and view all the answers

Which medication is primarily used as a vasodilator?

Nicorandil Signup and view all the answers

Beta blockers are effective for all types of angina.

False Signup and view all the answers

What is the onset time for sublingual nitroglycerin?

about 3 minutes Signup and view all the answers

The molecule Nicorandil has a dual effect leading to vasodilatation of the ____________ and peripheral vessels.

coronary artery Signup and view all the answers

Match the following nitrate therapies with their onset times:

Amyl nitrite = about 20 seconds Glyceryl trinitrate = about 2 minutes Isosorbid dinitrate = 4-6 hours Isosorbid mononitrate = about 3 minutes Signup and view all the answers

Which of the following is NOT a method of administration for nitrate therapy?

Intravenous infusion Signup and view all the answers

Isosorbid mononitrate has a longer duration of action compared to sublingual nitroglycerin.

True Signup and view all the answers

Name a common side effect associated with vasodilators.

Headache Signup and view all the answers

What is the primary mechanism of action for organic nitrates in treating angina?

Vasodilation by releasing NO Signup and view all the answers

Name one common application of organic nitrates in angina management.

Acute attacks of angina Signup and view all the answers

Organic nitrates are primarily administered orally.

False Signup and view all the answers

Organic nitrates can be administered using various forms such as sublingual tablets, transdermal patches, or __________.

ointment Signup and view all the answers

Match the nitrate medication with its description:

Amyl nitrite = Used for emergency angina attacks Isosorbide dinitrate = Long-acting nitrate Glyceryl trinitrate = Commonly used for angina prevention Isosorbide mononitrate = Effective for chronic angina management Signup and view all the answers

Which of the following statements is true regarding low molecular weight esters?

They are volatile and highly lipophilic. Signup and view all the answers

Calcium channel blockers are primarily used to enhance vasodilation.

False Signup and view all the answers

What is the primary effect of vasodilators in angina management?

Reduction of myocardial oxygen demand Signup and view all the answers

Study Notes

Bipyridine Derivatives

Amrinone and Milrinone are bipyridine derivatives that act as phosphodiesterase inhibitors, increasing the levels of cyclic adenosine monophosphate (cAMP) in the heart.
This leads to positive inotropy, meaning increased heart contractility, and vasodilation, which helps to reduce preload and afterload on the heart.
A common side effect of bipyridine derivatives is arrhythmias.

Beta Blockers

Beta blockers are primarily used for angina pectoris.
They work by blocking the effects of beta-adrenergic stimulation, leading to a reduction in heart rate, blood pressure, and myocardial oxygen demand.
They are effective for all types of angina.

Organic Nitrates

Organic nitrates are esters of alcohols with nitric acid.
They are primarily used as vasodilators, leading to a decrease in blood pressure and an increase in blood flow.
Organic nitrates are administered in various forms, including sublingual tablets, transdermal patches, and oral medications.
A common side effect of organic nitrates is headache.

Nicorandil

Nicorandil is a drug with a dual effect on vasodilation.
It acts as a potassium channel opener and a nitrate, resulting in vasodilation of both coronary and peripheral vessels.

Treatment of Angina with Nitrates

Sublingual nitroglycerin has an onset time of approximately 2-3 minutes.
Isosorbide mononitrate has a longer duration of action compared to sublingual nitroglycerin.
Transdermal patches have a slow onset time, but provide sustained nitrate delivery for several hours.
Oral nitroglycerin also has a relatively slow onset of action.

Low Molecular Weight Esters

Low molecular weight esters are metabolized quickly and have a short duration of action.

Effect of Vasodilators

Vasodilators primarily reduce myocardial oxygen demand by lowering pre-load and after-load on the heart.

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Description

This quiz covers key concepts related to cAMP's role in cardiac contractility, the use of bipyridine derivatives like Milrinone for CHF management, and various drug categories for treating angina pectoris. Test your understanding of these pharmacological agents and their implications in cardiovascular therapy.