Page 225 - Basic _ Clinical Pharmacology ( PDFDrive )

CHAPTER 12 Vasodilators & the Treatment of Angina Pectoris 211

McGillian MM et al: Management of patients with refractory angina: Canadian Ohman EM: Clinical practice. Chronic stable angina. N Engl J Med 2016;
Cardiovascular Society/Canadian Pain Society joint guidelines. Can J Cardiol 374:1167.
2012;28(Suppl2):S20. Peng J, Li Y-J: New insights into nitroglycerin effects and tolerance: Role of
McLaughlin VV et al: Expert consensus document on pulmonary hypertension. calcitonin gene-related peptide. Eur J Pharmacol 2008;586:9.
J Am Coll Cardiol 2009;53:1573. Rajendra NS et al: Mechanistic insights into the therapeutic use of high-dose
Mohler ER III: Medical management of claudication. UpToDate, 2013. www. allopurinol in angina pectoris. J Am Coll Cardiol 2011;58:820.
uptodate.com. Saint DA: The cardiac persistent sodium current: An appealing therapeutic target?
Moss AJ et al: Ranolazine shortens repolarization in patients with sustained inward Br J Pharmacol 2008;153:1133.
sodium current due to type-3 long QT syndrome. J Cardiovasc Electro- Sayed N et al: Nitroglycerin-induced S-nitrosylation and desensitization of
physiol 2008;19:1289. soluble guanylyl cyclase contribute to nitrate tolerance. Circ Res 2008;
Müller CE, Jacobson KA: Recent developments in adenosine receptor ligands 103:606.
and their potential as novel drugs. Biochim Biophys Acta 2011;1808: Stone GW et al: A prospective natural-history study of coronary atherosclerosis.
1290. N Engl J Med 2011;364:226.
Münzel T et al: Physiology and pathophysiology of vascular signaling controlled by Triggle DJ: Calcium channel antagonists: Clinical uses—Past, present and future.
guanosine 3’,5’-cyclic monophosphate-dependent protein kinase. Circula- Biochem Pharmacol 2007;74:1.
tion 2003;108:2172. Wei J et al: Nicorandil stimulates a Na /Ca exchanger by activating guanylate
+
2+
Münzel T, Gori T: Nitrate therapy and nitrate tolerance in patients with coronary cyclase in guinea pig cardiac myocytes. Pflugers Arch 2016;468:693.
artery disease. Curr Opin Pharmacol 2013;13:251.

PREP AR A TIONS C ASE STUD Y ANSWER
A V AIL ABLE

The case described is typical of coronary artery disease in
GENERIC NAME AVAILABLE AS a patient with hyperlipidemia. Her hyperlipidemia should
NITRATES & NITRITES be treated vigorously to slow progression of, and if pos-
Amyl nitrite Generic sible reverse, the coronary lesions that are present (see
Isosorbide dinitrate (oral, oral sustained Generic, Isordil
release, sublingual) Chapter 35). Coronary angiography is not indicated unless
Isosorbide mononitrate Ismo, others symptoms become much more frequent and severe; revas-
Nitroglycerin (sublingual, buccal, oral Generic, others cularization may then be considered. Medical treatment of
sustained release, parenteral, transdermal
patch, topical ointment) her acute episodes of angina should include sublingual tab-
CALCIUM CHANNEL BLOCKERS lets or sublingual nitroglycerin spray 0.4–0.6 mg. Relief of
Amlodipine Generic, Norvasc, discomfort within 2–4 minutes can be expected. To prevent
AmVaz episodes of angina, a β blocker such as metoprolol should
Clevidipine (approved only for use in Cleviprex
hypertensive emergencies) be tried first. If contraindications to the use of a β blocker
Diltiazem (oral, oral sustained release, Generic, Cardizem are present, a medium- to long-acting calcium channel
parenteral) blocker such as verapamil, diltiazem, or amlodipine is likely
Felodipine Generic, Plendil to be effective. Because of this patient’s family history, an
Isradipine (oral, oral controlled release) DynaCirc
Nicardipine (oral, oral sustained release, Cardene, others antiplatelet drug such as low-dose aspirin is indicated. Care-
parenteral) ful follow-up is mandatory with repeat lipid panels, repeat
Nifedipine (oral, oral extended release) Adalat, Procardia, dietary counseling, and lipid-lowering therapy; coronary
others
Nisoldipine Sular angiography should also be considered if her condition
Verapamil (oral, oral sustained release, Generic, Calan, worsens.
parenteral) Isoptin
BETA BLOCKERS
See Chapter 10
SODIUM CHANNEL BLOCKERS
Ranolazine Ranexa
DRUGS FOR ERECTILE DYSFUNCTION
Avanafil Stendra
Sildenafil Viagra, Revatio
Tadalafil Cialis, Adcirca
Vardenafil Levitra
DRUGS FOR PERIPHERAL ARTERY DISEASE
Cilostazol Generic, Pletal
Pentoxifylline Generic, Trental