Anesthesia Pharmacology Chapter 10: Pharmacology of
Antianginal Drugs
Click on the correct answer.
Prinzmetal's angina --
- exertional
- rest
Causes of myocardial ischemia
- arterial thrombus
- coronary vasospasm
- coronary vessel atherosclerosis
- B & C
- A, B & C
In the absence of atherosclerotic disease, intramyocardial resistance arterioles can significantly dilate
- true
- false
Factors that increase myocardial oxygen requirements:
- enhanced contractility
- reduced wall tension
- increased heart rate
- B & C
- A & C
Drug effects that may prevent/terminate angina:
- coronary vasodilators
- negative inotropic drugs
- peripheral vasodilators
- negative chronotropic drugs
- all of the above
More important for coronary blood flow control:
- local metabolic factors
- nervous system regulation
Possible vasodilatory substances responsible for local coronary blood flow regulation:
- prostaglandins
- hydrogen ions
- adenosine
- B & C
- A, B & C
Coronary blood flow -- sympathetic activation:
- associated with more coronary vasoconstriction
- associated with more coronary vasodilation
Preferred for acute management of angina:
- nitroprusside sodium (Nipride)
- hydralazine (Apresoline)
- sublingual nitroglycerin
- propranolol (Inderal)
- minoxidil (Loniten)
Principal mechanism by which sublingual nitroglycerin terminates anginal episodes in patients with advanced atherosclerotic coronary vessel disease:
- coronary vasodilation
- decreased afterload
- decreased preload
- decreased heart rate
- decreased contractility
Drugs clinically used for management of angina --
- atenolol (Tenormin)
- propranolol (Inderal)l
- nadolol (Corgard)
- metoprolol (Lopressor)
- all of the above
Management of variant (Prinzmetal's) angina:
- propranolol (Inderal)
- verapamil (Isoptin, Calan)
- both
- neither
Substrate for nitric oxide synthase for production of endogenous nitrates:
- phenylalanine
- arginine
- proline
- tranylcypromine (Parnate)
- tryptophan
Organic nitrate/nitrates following denitration to produce NO, cause these effects on second messenger systems:
- decrease cGMP
- activation guanylate cyclase
- both
- neither
More likely associated with low-dose nitrates
- reduced and-diastolic left and right ventricular chamber size and pressures
- reflex-mediated tachycardia along with substantial venous pooling and arteriolar dilation