PHA 3112 Chapter Notes - Chapter 75: Deep Vein Thrombosis, Torsades De Pointes, Coronary Vasospasm
10 Dec 2016
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Chapter 51 - drugs for angina pectoris: metoprolol [betaloc, lopressor]: Metoprolol: beta blocker 1st line for chronic, stable angina but not effective for vasospastic angina. Therapeutic use: provide sustained protection against induced angina pain on fixed schedule, decrease death risk, especially prior mi. Exercise tolerance increased; frequency & intensity of angina attacks reduced: nitroglycerin [nitro-dur, nitrostat, others] Pharmacologic action: frequently used organic nitrate antianginal drug; effective, fast, & expensive. Therapeutic use: doc for relieving acute angina attacks. Vasodilation mechanism action: by acting on vascular sm & conversion of nitrate (nitroglycerin) to nitric oxide (active form) Mechanism of antianginal effects: stable angina: by decreasing cardiac oxygen demand but not cardiac supply, variant angina: by relaxing/preventing spasm in coronary arteries = increase oxygen supply; not od. Adverse effects: 1) vasodilation, 2) headache, 3) orthostatic hypotension, 4) reflex tachycardia. Drug interaction: intensify w/ other hypotensive drugs & w/ beta blockers, ccb, diuretics, & any bp.
