Pharmacology notes

Apr 15th, 2015
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Pharmacology notes

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Drugs used in AnginaEU MBCHB 3 (Pharmacology II)DR D M KILLINGOPhysician / CardiologistBut, first, some muscle review!Angina pathogenesisDrugs Used in Angina Pathogenesis of Acute Coronary SyndromeDrugs Used in Angina Angina pectoris ischemia of the heartmuscle as a result of coronary artery occlusionor blockage. Drugs use to decr the work load of the heartand hence, O2 demand. Nitrates are the 1st-line drugs peripheralvasodilation, especially in the veins by actingon vascular smooth muscle that involves theformation of NO and [cGMP]cyto.Nitrates (contd) The cGMP pooling of blood in the veins decrvenous return and the ventricular vol is decr. Decr in the distension of the heart wall decrO2 demand and the pain is quickly relieved.Nitrates Short-acting nitrates: Glycerol trinitrate (sl, tablet,or spray) acts for ~ 30 min.-More useful in preventing attacks than instopping them once they have begun.-Patches (transdermal) have longer duration ofaction (~ 24 hr). Long-acting nitrates are more stable and effectivefor several hr. Isosorbidedinitrate widely used, but metabolizedrapidly by liver. Isosorbidemononitrate (active metabolite) of dinitrateavoids the variable absorption and unpredictable 1stpass metabolism of the dinitrate.Nitrates (contd) Adverse effects: Aterial dilation headaches,hypotension and fainting, and in severe cases,reflex tachycardia.- Can be counteracted

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