Attacks which occur at rest
Is relieved by glyceryl trinitrate
Is often a prelude to myocardial infarction
Attacks that occur with increasing frequency and intensity
Attacks that occur on less and less exertion
White thrombus (platelet/fibrinogen/fibrin aggregates)
Spasm of the smooth muscle of the coronary arteries
A presence of endothelium-derived vasodilators
Smoking
A relative deficiency of endothelium-derived vasodilators
Need not stop smoking
Require urgent antiplatelet therapy
If treated with glyceryl trinitrate then a constant i.v. infusion should be used
Pain should be easily relieved by glyceryl trinitrate sublingually
Are treated by i.v. heparin and beta-blockers
A... acute prophylaxis
A... longer prophylaxis
B... volatile
B... not volatile
B... to be stored in a cool place in a tightly capped dark container
Orally
Sublingually
Transdermally
In a spray
Immediately before undertaking strenuous activity
Glyceryl trinitrate for pain relief
Acute prophylaxis by sublingual buccal administration of organic nitrates
Longer prophylaxis by oral organic nitrates
Beta-adrenoceptor blockers
Calcium channel blockers
Nitric oxide is generated
The vascular smooth muscle is contracted
Platelet function is inhibited
Chest pain is relieved
Non-vascular smooth muscles are not influenced
A...arteriolar rather than venous smooth muscle
A...venous rather than arteriolar smooth muscle
B...reduce cardiac preload
B...increase cardiac work and oxygen demand
B...improve coronary blood flow
A...loss of efficacy of the drugs
A...due to exhaustion of sulfydryl-containing intermediary
A...a long-term event
B...by intermittent dosage
B...by omitting the evening dose in patients who do not experience angina at night
A...as an endothelium-derived relaxing factor
A...in an endothelium-independent manner
B...only if endothelial function is normal
B...also if endothelial function is severely impaired
B...in many patients with coronary artery disease
Is determined by presystemic drug biotransformation
Is higher as opposed to that from the sublingual space
Is higher as opposed to that from the buccal mucosa
Is useful for minimizing adverse effects of the sublingual tablets if they are swallowed
Can be influenced by molecule modification