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Pharmacology II Exam 2 (Lauren) > Antanginals Based On Review > Flashcards

Antanginals Based On Review Flashcards

1
Q

What is a risk of all vasodilators?

A

Risk of decreasing coronary flow

Shortened diastole, lowered perfusion pressure during diastole

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2
Q

What is the MOA of nitrates/nitrites?

A

It increases the release of NO

No stimulates Guanylyl Cycylase= lots of cGMP

Lots of cGMP=Myosin LC RELAXATION

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3
Q

Which does nitroglycerin dilate more: veins or arteries

A

Large Veins

Uneven vasodilation

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4
Q

Why do nitrites help in angina?

A

Decreasing myocardial O2 requirement!

(They decrease preload (venous dilation)

Decrease afterload (some arteriole dilation))

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5
Q

Do nitrates cause reflex tachycardia

A

Oh yeah ⏱

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6
Q

Why is nitroglycerin taken sublingually?

A

Because if you give it orally, the liver will destroy almost all of it on the “first pass”

This allows for rapid absorption and immediate angina relief

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7
Q

How long does it take for nitrates to kick in

A

1-3 min

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8
Q

What are the adverse effects of nitroglycerin

A

Throbbing headaches (big diff b/w diastolic and systolic pressure)

Orthosstatic hypotension

Tachycardia

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9
Q

Can patients use nitroglycerin long term?

A

No, they will build up tolerance fast

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10
Q

What is “Monday disease”

A

Guys who make explosives would get headaches and dizziness on Monday and Tuesday, and then by Friday, their symptoms would disappear due to developing tolerance to nitro over the week.
Then by the following Monday, sensitivity is restored and their headaches are back.

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11
Q

What is the IV form of nitro?

A

Nitroprusside

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12
Q

What is the MOA of calcium channel blockers?

A

Block calcium channel on membrane of muscle cells

=no ca/calmoduliun to activate myosin LC Kinase

=muscle contraction impossible

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13
Q

What are the 3 main calcium channel blockers discussed in this lecture

A

Nifedipine (and other dihydropyridines -dipines)

Verapamil

Diltiazem

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14
Q

Which CCB has the MOST effect on vascular smooth muscle

A

Nifedipine (and other -dipines)

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15
Q

Which CCB has the LEAST effect on vascular smooth muscle

A

Verapamil

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16
Q

Which CCB has the MOST effect on the heart muscle?

A

Verapamil

17
Q

Which CCB has the least effect on the heart muscle?

A

Nifedipine

18
Q

Do we give nifedipine for HTN or angina?

A

HTN ONLY

Strong vasodilation, very little effect on heart

19
Q

Which calcium channel blocker may cause angina pectoris

A

Nifedipine due to huge vasodilation and subsequent major drop in diastolic BP

20
Q

CCBs are good for (Chronic/acute) angina

A

Chronic

21
Q

Can we use beta blockers for Prinzmetals angina

A

NO!!! NO!!! NO!!! They are NOT VASODILATORS

22
Q

Will beta blockers have any vasodilation

A

NO**

23
Q

If B blockers dont have any vasodilation effect, how do they help with angina?

A

Decrease SNS activity= slower HR and less vasoconstricion

Bradycardia= increased myocardial perfusion time

24
Q

What are the adverse effects of beta blockers?

A

Bronchoconstriction!!!!

Increased Triglycerides

Decreased insulin and hypoglycemic response

25
Q

What does Ranolazine (Ranexa) do?

A

It is a decreases LV stiffness and improves coronary circulation

Used only when other anti-angina medications dont work

26
Q

What two conditions are NOT good for beta blockers

A

Asthma

Diabetes

27
Q

What kind of antianginal should you avoid if patient has a peptic ulcer 🔥

A

CCB

Relaxes ALL smooth muscles which slows gastric emptying=ulcer made worse

28
Q

How do PDE5 inhibitors work?

A

They inhibit PDE5 lol

This keeps cGMP around which= profound vasodilation in your peepee

29
Q

What drug do you NEVER EVER combine PDE5 inhibitors with

A

Nitrates

30
Q

What drugs do you need to be CAREFUL combining with PDE5 inhibitors

A

All vasodilators

31
Q

What are the 2 indications for sildenafil

A

ED

Pulmonary hypertension

32
Q

What is the half life of sildenafil (viagra)

A

4 hours

33
Q

What is the most interesting side effect of sildenafil (viagra)

A

Visual impairments including a blue tinge to vision, photophobia or blurred vision

34
Q

Why cant pilots take viagra writhing 8 hours of flying

A

Makes white lights look blue= wrong way driver on the runway 👨🏼‍✈️🛬💥

35
Q

What makes the new ED drugs different from Viagra?

A

They are more selective for PDE5 than PDE6 (in retina) = less visual disturbances

36
Q

What is the difference between Vardenafil (Levitra), Avanafil (Stendra), and Tadalafil (Cialis)?

A

Vardenafil and Avanafil= Very soon (onset of action within 15 min)

Tadalafil= Tomorrow. (24-36 hr duration of action= spontaneity!)

Pharmacology II Exam 2 (Lauren) (9 decks)

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