USMLE Step 1
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| 3 Classes of Anti-anginal Drugs | 1. Nitrates, 2. Beta blockers, 3. Ca channel blockers
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| Nitroglycerin [generates metHb (Fe3+) binds toxic cyanide = antidote] | MOA: nitrate, drug of choice 4 prompt relief of angina due to exertion or emotional stress, significant 1st pass in liver-better sublingual, decreases coronary vasoconstriction to perfuse the heart & relax coronary arteries; ADRs: high dose = reflex tachy
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| Isosorbide dinitrate | MOA: nitrate, decreases coronary vasoconstriction and perfuse the heart by relaxing the coronaries, used for chronic maintenance since not readily metabolized by liver and thus given PO, less potent than nitroglycerin
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| Nifedipine | MOA: Ca channel blocker affects smooth muscle in peripheral vasculature w/ little to no effect on the heart, thus allows for heart to pump vs. less mmHg, relaxes arterioles, best for Prinzmetal angina
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| Verapamil | MOA: Ca channel blocker that affects heart (slows HR) w/ some significant vasculature effect, causes the heart to work less & thus requires less O2, DOC for Prinzmetal angina (cardiac chest pain at rest that occurs in cycles); ADR: reflex tachy
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| Propranolol | MOA: beta-blocker that decreases the work of the heart and O2 demand used for daily antianginal tx and standard in acute unstable angina & MI
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| Metoprolol | MOA: beta-blocker that decreases the work of the heart and O2 demand used for daily antianginal tx and standard in acute unstable angina & MI
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| Classic Angina | -substernal pain, -lasts < 10 mins, -relieved by rest & nitrates
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| Myocardial Infarction | -substernal pain -> spreads to arms or jaw, -lasts > 30 mins, -not relieved by rest or nitrates
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Created by:
jerrica_08
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