NURS 2004 Lecture Notes - Lecture 16: Isosorbide Dinitrate, Angina Pectoris, Beta Blocker

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Therapy for ischemic heart disease (myocardial infarction and. Myocardial infarction: hypoxia to myocardial tissue resulting from ischemia (tissue death) Angina pectoris: sudden pain beneath the sternum often radiating to left shoulder and arm; oxygen supply to the heart is insufficient to meet oxygen demand. Chronic stable angina (exertional): chest pain brought on by excretion. Variant angina (prinzmetal"s): spasm of a vessel. Moa: binds to vascular smooth muscle cell receptors changed to nitric oxide by sulfhydryl groups, which activates an enzyme to form cyclic gmp high cyclic gmp levels dephosphorylation of myosin, preventing interaction with actin causing vsm relaxation and vasodilation. Decrease flow to the subendocardium with increase coronary perfusion. O2 supply and demand in the healthy heart and heart with. In cad, coronary arteries are unable to dilate and increase flow in response to demand. Dilates bronchial, uterine, urethral, gi smooth muscle. Tolerance- so need ntg-free period (patch on 12 hr, off 12hr)

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