antiangina

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Anonymous
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298785
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antiangina
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2015-03-20 14:58:24
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antiangina
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  1. Organic Nitrates
    • – Decrease myocardial oxygen consumption
    • – Used in conjunction with propranolol to reduce
    • tachycardia
    • – Used for aborting angina attacks; used as prophylaxis
    • against predictable attacks
    • – Converts to nitric oxide to have effect
    • – Can result in reflex tachycardia, venous dilation,
    • decreased afterload, increased cardiac force
    • – Use is contraindicated with sildenafil (Viagra)
  2. Beta antagonists
    • – Action by decreasing heart rate and
    • contractility
    • – Used with organic nitrates to inhibit reflex
    • tachycardia
    • – Blocks exercise induced tachycardia
    • – Decrease arterial pressure
  3. Calcium Channel blockers
    • – Cardiac vs. smooth muscle selectivity
    • – Relaxes vasospasm
    • – Decreases heart rate and contractility
    • – Side effects bradycardia and AV block
  4. Heparin
    • – LMW heparin – less monitoring, less
    • variability in response, longer duration of
    • action (better for long distance people)
    • – Binds to anti-thrombin III
    • – Overdose is treated by protamine sulfate
  5. • Warfarin
    • – Factors affected by warfarin – II, VII, IX, X,
    • protein C and S
    • – Reversed by vitamin K
    • – Not used in pregnancy
  6. • Anti-platelet drugs
    • – monoclonal antibody
    • to IIbIIIa receptor, aspirin (mechanism of
    • action, typical drugs)
  7. • Fibrinolytic (thrombolytic) system –
    • – Activators – urokinase, t-PA, streptokinase,
    • etc.
    • – Inhibitors – aminocaproic acid
    • – Abnormal bleeding is the most common side
    • effect
  8. Heart Failure Pharm First line of treatment
    – ACE inhibitors
  9. • Systolic Dysfunction
    • – impaired contractile
    • properties
  10. • Diastolic Dysfunction
    • – inability of the heart to fill (decreased compliance,
    • reduced relaxation)
  11. ACE inhibitors
    • – Reduces AngII production
    • – Enhances diuretic therapy
    • – Should not be used in pregnancy
  12. • Phosphodiesterase Inhibitors
    • – Milrinone used for short-term support
    • – Milrinone bypasses beta1 receptor stimulation
    • to produce inotropic activity
  13. Cardiac Glycosides
    • – MOA – inhibit Na/K ATPase
    • – Use digoxin immune antibody to reverse the effects
  14. • Beta-blockers
    • – sudden withdrawal may cause
    • death – alleviates compensatory increase in
    • heart rate and renin release
  15. • Vasodilators
    – used for reducing afterload
  16. • Inotropic drugs
    • – Dobutamine has vasodilator properties, stimulates
    • adrenergic receptors – useful for immediate drug
    • therapy
  17. Treatment for Diastolic Dysfunction -
    • controversial
    • – Calcium channel blockers
  18. Calcium channel blockers
    • • Contraindicated in systolic dysfunction
    • • Improves relaxation and reduces HR
    • • Promotes regression of hypertrophy

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