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Nurulsri Anti Anginal and Infarkmyocard
Nurulsri Anti Anginal and Infarkmyocard
Nurulsri Anti Anginal and Infarkmyocard
O2 supply increases →
vascular blockage
SYMPTOMS THE
EMERGENCE OF ANGINA
O Severe pain under the sternum that radiates
to the arms, shoulders, neck or jaw area.
O Arise when walking up stairs or exertion
when after eating.
O The duration of angina pectoris is 5-30
minutes
Images Of Coronary Arteries
Angina Drugs
Classification of Drugs
O organic nitrates
O calcium channel blockers
O β blockers
NITRATES
Nitrates benefit patients with variant angina by relaxing
the smooth muscle of the epicardial coronary arteries and
relieving coronary artery spasm.
Mechanism of action:
Causes vasodilation / dilation of peripheral and coronary
arteries
Effects on the heart:
Reducing oxygen, myocardial / cardiac requirements and
increasing myocardial / cardiac oxygen supply
NITRATES
O Nitroglycerin
Releases nitric oxide in smooth muscle, which activates guanylyl
cyclase and increases cGMP.
O Trade marks: Nitrokaf Retard, Glyceryl Trinitrate DBL, Nitral, NTG
O Dose:
-Oral tablets : 2.6-2.8 mg 3 times a day or 10 mg 2-3 times a day.
-Sublingual tablets :0.15–1.2 mg, placed just under the tongue.
Duration of actions is 10-30 minutes.
-Heart attack: 10-100 mcg / minute
O Side Effects:
O Great dizziness
O Passed out
O Blurred vision
O Pale and cold sweat
O Shortness of breath
O Pounding.
Example of drug
O Isosorbid dinitrat (ISDN)
O Dose
Adults: 5 mg/day, a maximum of 10 mg/day. Elderly: start 2.5
mg/day.
O Side effects : Swelling in hands or feet, Palpitations or fluttering
in the chest; or Chest pain or severe feeling, pain spreading to
the arm or shoulder, nausea, sweating, general feeling of pain
O This drugs works by suppressing the effects of the hormone
epinephrine or adrenaline, which is a hormone that plays a
role in blood flow, so that the heart beats slower and works
less, and blood pressure drops. In addition, this drug also
helps dilate blood vessels so that blood circulation runs
smoothly.
O Nonselective beta blockers: In charge of blocking beta-1 and
beta-2 receptors with effects that affect the heart, blood
vessels, and respiratory tract. Types of beta nonselective
inhibitors are carvedilol, propranolol, and thymolol.
Type Of Beta Blockers based on beta receptors that
are inhibited and their effects on the body
1.
Selective beta blockers
2.
Nonselective beta blockers
In charge of blocking beta-1 and beta-2 receptors with effects that affect the
heart, blood vessels, and respiratory tract. Types of beta nonselective
inhibitors arecarvedilol, propranolol, andthymolol.
1. Propranolol (Non selective betha- blockers)
Propranolol was the first β blocker shown to
be effective in hypertension and ischemic heart
disease. Propranolol has now been largely replaced
by cardioselective β blockers such as metoprolol
and atenolol.
All β-adrenoceptor–blocking agents are
useful for lowering blood pressure in mild to
moderate hypertension
O Trade marks: Farmadral ® tablets (Fahrenheit) 10
mg, Inderal ® tablets (Astrazeneca) 10 mg, 40
mg.
2. Atenolol (Selective betha- blockers)
O Trade marks : Betablok, Farnormin 50, Internolol 50,
Lotenac, Niften, Tenblok, Tenormin, Tensinorm
O Indications : Angina pectoris , Hypertension
O Form of medicine : tablets
O Dose: Adults: 50-100 mg, once a day . The maximum
dose is 200 mg per day.
Infark Myocard
Myocard Infarct or heart attack is a condition where
the death of heart cells due to blood supply to certain
areas of the heart is reduced or obstructed.
1. Aspirin
O Trade marks : Ascardia, Aspilets, Farmasal, Miniaspi 80,
Thrombo Aspilets
O Dose : 160-325 mg a few minutes after symptoms.
O Side Effects :
Bronchospasm; gastrointestinal bleeding (sometimes severe), as
well as other bleeding (eg sub-conjunctival).
Blood Vessel Dilation
(Vasodilator)
O This drug works by affecting the muscles in the walls of arteries and
veins. Vasodilators reduce the tension in the muscle walls of blood
vessels, so that the space in the blood vessels does not narrow.
O This will make it easier for the body to drain oxygenated blood
throughout the body, including the heart muscle, and suppress the
potential for blood flow back to the heart's chamber.
1. Nitroglycerin
O Dose:
-Oral tablets : 2.6-2.8 mg 3 times a day or 10 mg 2-3 times a day.
-Sublingual tablets :0.15–1.2 mg, placed just under the tongue.
Duration of actions is 10-30 minutes.
-Heart attack: 10-100 mcg / minute
Statin (Cholestrol Drug)
O Atorvastatin
O Mechanism Of Actions :
reduce cholesterol levels with reduce LDL levels that
are too high in the blood
O Trade marks : Atorvastatin, Atofar, Atorwin,
Cholestor, Actalipid
O Dose : 10- 20 mg/d, The maximum dose is 80
mg/d.
O Side Effects :
Sore throat
Joint pain
Pain in the arm or leg
Diarrhea
Betha Blockres
O Bisoprolol
O Mechanism of Actions :
Bisoprolol works by reducing the frequency of heartbeats and
heart muscle pressure when contracting. That way, the
heart's burden in pumping blood throughout the body can be
reduced. With a fall in blood pressure, strokes and heart
attacks can be prevented.
O Trade marks : Beta-One, Bipro, Carbisol, Concor, Hapsen
O Side Effects :
Bradycardia
Diarrhea
Respiratory tract infections
Hard to breathe.
O Dose: 1,25-10 mg/d. The maximum dose is 20 mg/d.
Anticoagulant drugs
O Mechanism of Actions
To inhibit the formation of fibrin, and is used
prophylactically to reduce the incidence of
thromboembolism especially in veins.
O To prevent blood clots from occurring again
1. Enoxaparin
O Trade marks : Levenox
O Dose : 30 mg (IV) with 1 mg / kgBB (Sc)