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robbypowell's version from 2016-10-23 21:23

Angina Pectoris

Question Answer
What is the cause of Angina Pectoris?Greater oxygen demand in the myocardium than available supply (insufficient oxygen in Myocardium)
Chronic stable angina is due to ____% occlusion of coronary vessels60%
Angina can be experienced at rest with ____% coronary vessel occlusion90%
Angina pectoris is USUALLY (60% of the time) due to occlusion of which vessel?Coronary Artery
Up to ___% occlusion of coronary vessel can remain asymptomatic without stressor that increases myocardial oxygen demands60%
Angina drugs address the oxygen imbalance by affecting oxygen _________ (supply/demand)Demand
Surgeries address angina imbalance by affecting oxygen ________ (supply/demand)Supply
Of the causes for angina pectoris... ________ is a concern for dentistry because it can be precipitated by dentistryStress
Catecholamine release from ________ cells of ______ _______ (--> epi) increase venous return or ventricular size = inc work demand of the heart, inc HRChromaffin cells; Adrenal Medulla
The heart has an auto regulatory mechanism... increased oxygen demand induces ________ of coronary vesselsVasodilation
What is the site of Beta blockers when used to treat Angina?adrenergic B1 receptors on myocardium
Nitrates/nitrites act on what when used for angina pectoris?Vasculature (esp venous)
Calcium Channel Blockers block the influx of calcium where (when used for angina pectoris)?voltage dependent channels in membrane of cardiac musc cells
"Endothelial dependent Releasing factor" was later determined to be ______ ______Nitric Oxide
Organic nitrates lead to the release of ______ ______Nitric Oxide
_______ ________converts GTP to cyclic GMP (cGMP) → cGMP is imp for removal of Ca from cell and inducing vasorelaxationGuanylate cyclase
Nitrates and nitrates affect heart how?Decrease preload of myocardium (leading to less blood to pump through heart and thus less oxygen demand)
Define: amount of blood that rushes back to the heartPreload
Which nitrate/nitrite is taken sublingually?Nitroglycerine
T/F: Methemoglobinemia is associated with Nitrate/nitrite useTrue
T/F: Methemoglobinemia is associated with Ca Channel blocker useFalse
Calcium channel blockers are effective for all types of angina... but most effective for those caused by _______Vasospasm
______ _______ _______ cause gingival hyperplasia... _____ _____ are cardiodepressantsCa Channel Blockers; Beta-blockers
T/F: Beta-blockers are very effective against Prinzimetal Angina (vasospasm)False (questionable effectiveness)
T/F: Beta-blockers are questionably useful against Prinzimetal Angina (vasospasm)True (effective against all other forms)
Which class of angina drug is most called for with Prinzimetal Angina (vasospasm)Calcium Channel Blockers
T/F: Betablockers are useful against acute Angina attackFalse (Does NOT prevent attacks, but makes them less freq and severe = not used for acute attack, only used prophylactically (management))
T/F: Betablockers are not useful against Acute Angina AttacksTrue (Does NOT prevent attacks, but makes them less freq and severe = not used for acute attack, only used prophylactically (management)
When NO is administered as an anxiolytic, the mix should be ____% nitrous in Oxygen20%
Nonselective B blockers used with epi may cause ______Hypertension
Nitrates and B-Blockers may work well together by blocking reflex _________ due to nitrovasodilatorsTachycardia
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