IRAT Angina

what is angina

chest pain from myocardial ischemia

what are the three types of angina

stable, unstable, and variant (vasopastic/prinzmetals)

what are the 3 classes of drugs to treat angina

organic, nitrates, calcium channel blockers, and beta blockers

nitrates prototype

nitroglycerin

nitrates moa

increases cGMP, which decreases Ca-mediated contraction and dephosphorylates MLC leads to relaxation

nitrates clinical application

stable, unstable, variant

b-blockers prototype

propanolol

b-blockers moa

competitive inhibitors of norepinephrine and epinephrine at b1 (cardiac) and b2 (smooth muscle/lung) receptors; inhibit renin release

nitrates for

angina and acute coronary syndrome

b-blockers for

angina, HTN, migraines, anxiety

b-blockers application

stable and unstable

ca+2 channel blockers prototype for non-di

Verapamil

ca+2 channel blockers prototype for di

Nifedipine

ca+2 channel blockers for

angina, HTN, supravent.. tachycardia

ca+2 channel blockers moa

inhibition of L-type calcium channels (blocks contractions)

ca+2 channel blockers application

stable and variant

ranolazine moa

inhibits the late inward Na channel, preventing sustained Ca influx,

ranolazine for

chronic angina (isomeric heart disease)

nitrates are…

toxic with slidenifel and have a high tolerance

b-blockers are…

contradicted in VA, asthma, bronch., have unwanted effects; withdrawl symptoms

ca +2 channel blockers are…

first pass effect, high plasma protein binding (drug-drug int.), extensive metabolism and different ativity

ranolazine are…

due to hyperactivity of Na, Na+ overload in exchange for calcium, which creates a trigger for calcium overload

what is a foam cell

dysfunctional immune cell

what is stable

the most common, exercise induced (takes ab 5 mins)

what is unstable

needs ER, heart attack, progresses rapidly

what is variant?

spasms in the arteries of the heart

what does macrophage do?

scavenges for ApoB

what does chemokine do?

recruits monosites