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What is angina pectorals?
Chest discomfort due to myocardial ischemia
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Which category does unstable angina belong to?
Acute coronary syndromes
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What is another name for stable angina?
Exertion also angina
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Is there presence of plaque in stable angina?
Yes, lumen narrowed by plaque
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What causes pain in stable angina?
Inappropriate vasoconstriction
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What distinguish unstable angina form stable angina?
- Unstable angina has ruptured plaque
- Platelet aggregation and thrombus fomration
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In variant angina, is there plaque formation?
No, no overt plaques
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Main angina therapy targets what?
Myocardial oxygen consumption. Work to decrease wall stress, heart rate and contractility
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What is the preferred route of administration for organic nitrates?
Sublingual
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What affect on myocardial oxygen consumption does nitrate have?
Decrease end diastolic pressure thereby decreasing preload and wall stress
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What are the therapeutic uses for nitrates?
- Stable angina
- Variant angina
- Unstable angina
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What are adverse effects of nitrates?
- Throbbing headache (due to cerebral vessels dilation)
- Tachycardia
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What is a contraindication for nitrates?
Viagra (aka PDE-5 inhibitor)
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What are two Ca2+ channel blockers we learned?
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What is a physiologic effect of Ca2+ channel blocker use?
- Leads to reduction in contractility
- Dilation vascular smooth muscle —> decrease PVR, decrease after load and myocardial O2 demand
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True/False: Dihydropyridines have most effect on cardiac tissue
False, not much effect on cardiac tissue, more effects at vascular smooth muscle dilation
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What is a common side effect with verapamil?
Constipation
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What is an adverse effects with Ca2+ channel blockers?
Cardiac depression – cardiac arrest, bradycardia, AV block, heart failure
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What is a contraindication for Ca2+ channel blockers?
Heart failure
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What is the mechanism of action for beta blockers?
Blocks sympathetic activation
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What are some agents of beta blockers treatment for stable angina?
- Propranolol
- Metoprolol
- Atenolol
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What are adverse effects for beta blocker?
- Fatigue
- Impotence
- Lethargy
- Insomnia
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What are contraindication for beta blocker
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What is a therapeutic use for ranolazine?
Chronic angina
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What is the route of administration for ranolazine?
Oral
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What are adverse effects of ranolazine?
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