Drugs used in treatment of Angina Pectoris
In effort and variant angina predominantly are useful?
Beta-adrenoceptor blockers;
Calcium channel blockers;
alfa-adrenoceptor blockers;
ACE inhibitors.
Effort angina may occur when:
Oxygen demand increases;
Coronary artery reversibly constricts;
Episodes of angina occur at rest and when there is a change in the character, frequency, and duration of chest pain;
Transient spasm of localized portions of the vessels is usually associated with underlying atheromas.
Nitrates toxicities does not include:
Orthostatic hypotension;
Tachycardia;
Headache;
AV blockade.
Nitroglycerin increases the concetration of nitric oxide (NO) in vascular muscle cells and causes an increase in:
cAMP (cyclic adenosine monophosphate);
cGMP (cyclic guanosine monophosphate);
IP3 (inositol-1,4,5-triphosphate);
DAG (diacylgycerol).
Tolerence may be caused by a decrease in tissue sulfhydryl groups during action of:
Verapamil;
Nifedipine;
Nitroglycerine;
Metoprolol.
Beneficial effects of nitrates in the treatment of angina pectoris include:
Decreased ventricular volume;
Reflex tachycardia;
Reflex increase in contractility;
Decreased diastolic perfusion time.
Unwanted effects of nitrates in the treatment of angina pectoris include:
Decreased left ventricular diastolic pressure;
Increased collateral flow;
Vasodilation of epicardial coronary arteries;
Reflex tachycardia.
Calcium channel blockers may be used, except:
For prophylaxis of effort angina;
For prophylaxis of variant angina;
In vasospastic angina for prevention of coronary spasm;
Acute coronary syndrome, because they have little or no benefit.
Calcium channel blockers act in effort angina by:
Causing peripheral vasodilation;
Reduction of preload;
Increasing of cardiac work;
Increase coronary vasospasm.
Short-acting nitrates include:
Isosorbid dinitrate (oral);
Transdermal nitroglycerin;
Isosorbid mononitrate (oral);
Nitroglycerin (sublingual).
The beneficial effects of beta-blocking agents in angina pectoris are related to, except:
Decreased heart rate;
Reduced heart contractility;
Increased end – diastolic volume and ejection time;
Decreased myocardial oxygen consumption.
Beta-adrenoceptor blockers are not effective in:
Variant angina;
Arterial hypertension;
Effort angina;
Acute coronary syndrome.
Beta-adrenoceptor blocking agents are not vasodilators, with the possible exception of:
Propranolol;
Nebivolol;
Metoprolol;
Bisoprolol.
Contraindications to the use of B-adrenoceptor blockers are:
Heart failure (II functional class);
Arterial hypertension;
Asthma;
Effort angina.
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