GMS6530: ANTIANGINALS EXAM QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS

GMS6530: ANTIANGINALS EXAM QUESTIONS AND

ANSWERS WITH COMPLETE SOLUTIONS

coronary circulation during rest

4-5% of cardiac output

coronary circulation during stress

10-15% of cardiac output

T/FL blood flow through coronary arteries occurs primarily during diastole

True

wha are the determinants of oxygen demand?

1. heart rate

2. contractility

3. preload, afterload

what are the determinants of oxygen supply?

1. coronary patency

2. diastolic BP

3. blood O2 capacity

4. collateral circulation

ischemic heart disease

-oxygen demand > supply

-increased HR, contractility, preload, and afterload

-decreased coronary blood flow leading to vasospasm, fxied stenosis/atherosclerosis,

, and thrombus

-leads to hypoxia --> angina ---> MI --> arrhythmias --> and sudden death

angina pectoris

-typical (stable)

-variant (prinzmetal)

-atypical (unstable)

Typical stable (angina) pectoris

1. fixed atherosclerotic narrowing

2. heavy substernal discomfort

3. nitroglycerin, B-adrenergic receptor antagonists

variant (prinzmetal) angina pectoris

1. coronary vasospasm

2. discomfort at rest

3. calcium channel blockers

atypical (unstable) angina pectoris

1. atherosclerotic plaque rupture, thrombosis

2. discomfort with stress or rest

3. anticoagulants, anti-platelet drugs

Drug classes that treat angina

-nitrates: nitroglycerin, isosorbide mono and dinitrate

-beta AR antagonists: metoprolol

-calcium channel blockers: verapamil, diltiazem, nifedipine

-Na channel inhibitor: Ranolazine