Angina drugs

Those of 2- and 4-substituted pyridines fall about half-way between those of toluene ca 40) and of a ketone ca 20)—the organoUthinms have significant azaenolate character (as shown in 558 and 559). A representative reaction is the synthesis of 560 . Lithiation of 2-methylpyridine to give 560 has also been used in the synthesis of the anti-angina drug perhexUine (Scheme 223). ... 

Coronary vasodiiator Older incorrect name for drugs useful in angina. Drugs that relieve angina of effort do not act primarily through coronary vasodilation some potent coronary vasodilators are ineffective in angina... 

The so-called calcium channel blockers constitute a class of cardiovascular agents that have gained prominence in the past few years. These drugs, which obtund contraction of arterial vessels by preventing the movement of calcium ions needed for those contractions, have proved especially useful in the treatment of angina and hypertension. Dihydropyridines such as nifedipine (30) are par-... 

Thromboxane A-2 has been implicated in a number of disorders of the circulatory system including coronary artery spasms, unstable angina pectoris, traumatic and endotoxic shock, and heart attacks. It is formed normally very near its receptors and is rapidly deactivated by metabolizing enzymes so circulating levels are quite low. Furthermore, it is opposed in its actions by the prostacyclins. When these controls are defective, pathology results and drugs can be the resort in attempts to restore the normal healthy balance. For one example, furegrelate (6) is a throm-... 

Older adultsare at increased risk for adverse reactions when taking the (3-adrenergic blocking drugs The nurse should monitor the older adult closely for confusion, heart failure, worsening of angina, shortness of breath, and peripheral vascular insufficiency (eg, cold extremities paresthesia of the hands weak peripheral pulses). 

These dm are primarily used in the treatment of hypertension (see the Summary Drug Table Adrenergic Blocking Drugs also see Chap. 39) and certain cardiac arrhythmias (abnormal rhythm of the heart), such as ventricular arrhythmias or supraventricular tachycardia They are used to prevent reinfarction in patients with a recent myocardial infarction (1—4 weeks after MI). Some of these dm have additional uses, such as the use of propranolol for migraine headaches and nadolol for angina pectoris. 

In many instances, the adverse reactions associated with tlie nitrates lessen and often disappear with prolonged use of die drug. However, for some patients, tiiese adverse reactions become severe, and the primary health care provider may lower the dose until symptoms subside The dose may then be slowly increased if the lower dosage does not provide relief from the symptoms of angina... 

Angina is a common problem in older adults When an older adult requires an antianginal drug, the dosage maybe reduced to compensate for impaired renal function or heart disease. Older patients are at increased risk for postural hypotension. Blood pressure and ability to ambulate should be monitored closely. 

Niacin is contraindicated in patients with known hypersensitivity to niacin, active peptic ulcer, hepatic dysfunction, and arterial bleeding. The drug is used cautiously in patients with renal dysfunction, high alcohol consumption, unstable angina, gout, and pregnancy (Category C). 

Benzothiazepines belong to the three classes of calcium channel blockers which are important cardiovascular drugs in the management of angina pectoris and hypertension. A diastereoselective one-pot synthesis of the trans-and ds-3-hydroxy-2-(4-methoxyphenyl)-2,3-dihydro-l,5-benzothiazepin-4-one nucleus, a key intermediate in the preparation of the calcium channel blocker Diltiazem, was carried out under microwave irradiation in an open vessel (Scheme 25). Control of the diastereoselectivity was achieved by vary-... 

C03-0117. Heart disease causes 37% of the deaths in the United States. However, the death rate from heart disease has dropped significantly in recent years, partly because of the development of new drugs for heart therapy by chemists working in the pharmaceutical industry. One of these drugs is verapamil, used for the treatment of arrhythmia, angina, and h q)ertension. A tablet contains 120.0 mg of verapamil. Determine the following quantities (a) the molar mass of verapamil (b) the number of moles of verapamil in one tablet and (c) the number of nitrogen atoms in one tablet. 

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