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Pharm Exam #2 - Antianginal drugs, heart failure drugs, antidysrhythmic drugs

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Pharm Exam #2 – Antianginal drugs, heart failure drugs, antidysrhythmic

Ch. 23 Antianginal Drugs
Angina medications are used for angina pectoris or chest pain. The types of chest pain are chronic stable angina (which is associated with atherosclerosis), unstable angina (early stage of progressive coronary artery disease), and vasospastic angina (which results from spasms in the layer of smooth muscle that surrounds atherosclerotic coronary arteries). The three main classes of drugs used to treat angina pectoris are nitrates and nitrites, betablockers, and calcium channel blockers. The goal of the treatment is:
1. Minimize the frequency of attacks and decrease the duration and intensity of angina pain
2. Improve the patient’s functional capacity with as few adverse effects as possible
3. Increase blood flow to ischemic heart muscle and decrease myocardial oxygen demand
4. Prevent or delay the worst possible outcome, which is a myocardial infarction
Nitrates and Nitrites Nitrates are available on many forms including sublingual, chewable tablets, oral capsules/tablets, IV solutions, transdermal patches, ointments and translingual sprays. They are broken down into rapid-acting forms and long-acting forms. The rapid-acting forms include sublingual and IV solutions. These are used to treat acute angina attacks. The long-acting forms are used to prevent angina episodes. Mechanism of Action
Nitrates dilate all blood vessels; however, they predominately affect venous vascular beds and have a dose-dependent arterial vasodilator effect. This vasodilation happens because of relaxation of smooth muscle cells.
1. Vasodilation results in reduced myocardial oxygen demand and therefore more oxygen to ischemic myocardial tissue and reduction of angina symptoms.
2. By causing venous dilation, the nitrates reduce venous return and in turn reduce the left ventricular end-diastolic volume (preload) and results in a lower left ventricular pressure.
Contraindications Known drug allergy, severe anemia, closed-angle glaucoma, hypotension, and severe head injury. Contraindicated with the use of erectile dysfunction drugs because these are also vasodilatory.

 

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Pharm Exam #2 - Antianginal drugs, heart failure drugs, antidysrhythmic drugs

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