Karch Chapter 46: Anti-Anginal Agents Flashcards

A set of vocabulary flashcards covering the pathophysiology of coronary artery disease and the primary pharmacological agents used to treat angina pectoris.

Angina Pectoris

Chest pain resulting from a myocardial oxygen supply–demand mismatch.

Atherosclerosis

The narrowing of arteries induced by the buildup of plaque.

Atheromas

Fatty lesions found within the walls of blood vessels.

Coronary Artery Disease (CAD)

A condition characterized by the progressive narrowing of coronary arteries.

Myocardial Infarction (MI)

Muscle necrosis resulting from a complete coronary occlusion and subsequent ischemia.

Pulse Pressure

The difference between systolic and diastolic pressure ($\text{Systolic} - \text{Diastolic}$), which reflects the coronary perfusion pressure.

Atherosclerotic Cardiovascular Disease (ASCVD)

A disease state involving plaque buildup in arterial walls, leading to narrowed vessels and potential complications like PAD, stroke, or CAD.

Stable Angina

Predictable chest pain, typically triggered by exertion and relieved by rest.

Unstable Angina

Unpredictable chest pain that occurs at rest and serves as a precursor to Myocardial Infarction.

Prinzmetal Angina

Chest pain caused by coronary vasospasms rather than just plaque; it often occurs at rest.

Substance P

A substance released by ischemic cells that facilitates the perception of pain.

Nitroglycerin

The prototype nitrate that relaxes vascular smooth muscle to decrease preload and afterload, featuring a rapid onset of $1-3\,\text{min}$ when administered sublingually.

Metoprolol

A prototype beta-1 selective adrenergic blocker that decreases heart rate and oxygen demand, with an oral onset of $\sim 15\,\text{min}$.

Diltiazem

The prototype calcium channel blocker that inhibits calcium influx in cardiac and arterial muscle, used to relieve vasospasm in Prinzmetal angina.

Ranolazine

A Piperazine Acetamide agent that may inhibit late sodium influx to decrease oxygen demand, characterized by a peak of $2-5\,\text{hrs}$ and a half-life of $T\frac{1}{2} \sim 7\,\text{hrs}$.

PDE5 inhibitors

A class of medications, including sildenafil, that can cause severe hypotension if taken concurrently with nitrates.

Reflex Tachycardia

A potential adverse effect resulting from the compensatory heart rate increase following nitrate-induced vasodilation.

Isosorbide dinitrate

A nitrate medication used for the prophylaxis and treatment of angina, similar in mechanism to nitroglycerin.