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MEDICATIONS FOR ANGINA/ATHEROSCLEROSIS - Coggle Diagram
MEDICATIONS FOR ANGINA/ATHEROSCLEROSIS
STATINS
Addresses dyslipidemia
Mechanism
Competitive inhibitor of hydroxymethylglutaryl (HMG) CoA reductase (rate limiting step in cholesterol biosynthesis)
Increases HDL
Reduces triglycerides
Risks
Adverse muscle events can happen sometimes
Hepatic dysfunction (rare)
Renal dysfunction (rare)
Diabetes (could affect glucose metabolism)
Examples
Atorvastatin
Fluvastatin
Lovastatin
Pitavastatin
Pravastatin
Rosuvastatin
Simvastatin
BETA BLOCKERS
Reduces sympathetic effects on HR and contractility (cardiac demand)
Mechanism
Blocks beta receptors (can be either cardioselective or nonselective)
Beta1 in heart muscle
Beta2 found in heart muscle but more prominent in bronchial/peripheral vascular smooth muscle
Beta3 found in adipose tissue
Examples
Acetbutolol
Atenolol
Betaxolol
Bisoprolol
Carteolol
Carvedilol
Esmolol
Labetalol
Levobunolol
Metoprolol
Nadolol
Nabivolol
Pindolol
Propranolol
Sotalol
Timolol
Risks
Bronchoconstriction (if nonselective)
Worsening of peripheral artery disease/Raynaud phenomenon
Fatigue
Nightmares, insomnia, hallucinations
Erectile dysfunction
ASPIRIN
Lowers chance of clot formation
Mechanism
Irreversibly inhibits cyclooxygenase-1 and 2
Irreversibly inhibits formation of thromboxane A2
Risks
Bleeding
Aspirin sensitivity (small minority of patients can't tolerate)
NITROGLYCERIN
Mechanism
Dilates large coronary arteries and arterioles (increased perfusion)
Dilation of venous system reduces preload
Systemic arterial dilation reduces afterload
Enhanced collateral blood flow
Cellular: enters vascular smooth muscle and forms S-nitrosothiols, which produce cGMP and cause relaxation)
Risks
Hypotension
Headache
Tachycardia
Contraindications
Systolic BP <90mmHg
Marked bradycardia (<50bpm)
Known/suspected RV infarction
Recent phosphodiesterase inhibitor (for ED)
Hypertrophic cardiac myopathy
Severe aortic stenosis
Dilates smooth muscle!
CALCIUM CHANNEL BLOCKERS
Block calcium channels in the heart muscle
Leads to decreased contractile force