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MNA Program
Fall 1999

Last updated 04/10/00 12:26 PM

5. Your patient's exertional angina is now refractory to the combination of nitroglycerin and propranolol, so her physician added a Ca2+ channel blocker to the regime. Discuss the rationale for co-administering the -blocker and nitrate (for initially treating the angina) and which Ca2+ channel blocker (i.e., verapamil, diltiazem or nimodipine) would be indicated (and why).

NO vasodilation venous pooling preload cardiac work.

NO can result in reflex tachycardia which the -blocker will blunt.

Ca2+ channel blockers

Also -blocker MVO2 demand on heart by CO and HR

Brody Page 18

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