Block 4 Pharmacology Final Exam

Block 4 Pharmacology Final Exam How venodilator treatment reduces preload/end-diastolic volume - by decreasing venous return How arterial dilator treatment reduces afterload/end-systolic volume - by decreasing arterial/aortic pressure Description of O2 supply of heart - ATP synth by aerobic metab w/ interm O2 supply (not continuous bl supp b/c BVs supp myocard constr during systole) - extr up to 70% O2 from blood Pathophysiology of IHD - 1). Stable angina = chron disr bl supp to myocard tiss by asymp athero plaque 2). Stable ischemia/angina = stab fixed athero plaque 3). Unstable ischemia/angina = plaque disr+plt aggreg but not yet thrombus formation 4). NSTEMI = thrombus form but not compl occlusive 5). STEMI = compl occl thromb Angina Pectoris Description & Types - press-like discomf/pain from myocard isch/underl athero -- O2 demO2 supp - IHD = angina+MI - Typ ang = O2 dem incr (ie. exerc/stress) but cor bl fl+O2 supp lim by athero - Stab ang = sim angina attacks each time - Unstab ang = ang attacks worse each time by rup plaque; MI forerunner - Variant/Prinzmetal's ang = ac cor vasosp w/ pain @ rest -- TREAT w/ CCBs/BBs Drug Classes used for Stable Angina Treatment - - Nitrites & Nitrates - CCBs - BBs - Drugs modifying myocard metab General Pharmacology of Drugs for Stable Angina Treatment - - Incr O2 supp by: incr reg fl distrib by nitrates, CCBs, BBs & incr cor bl fl by nitrates, CCBs - Decr O2 dem by: decr HR+contractility by BBs, CCBs & decr wall tens (pre+afterload) by nitrates, CCBs Examples & Use of Nitrites in Stable Angina Treatment - Amyl nitrite for ac ang by inhal Examples & Use of Nitrates in Stable Angina Treatment - incl nitroglycerin, isosorbide dinitrate, isosorbide mononitrate - Use = prev+treat ang attacks by pref relax ven sm musc (venodil) - IV nitro also for MI-assoc ac HF MOA & Effects of Nitrites & Nitrates in Stable Angina Treatment - - MOA = biotransf prod NO activ guanylyl cyl -- cGMP --sm musc relax -- vasodil (pref in veins) - Effects = pref dil ven sm musc to red preload -- decr vent wall tens -- decr O2 dem; cor art dil -- incr cor bl fl+distrib to subendoc -- incr O2 supp