Question
Rationale of combining beta blockers with long acting nitrates
Q8 1 marks Short Answers ★ ✓
Answer
Long-acting nitrates cause venodilatation (↓preload) and reflex sympathetic activation, which produces reflex tachycardia and increased myocardial contractility — both of which increase myocardial oxygen demand and can offset the anti-anginal benefit. Beta-blockers block this reflex tachycardia and also reduce heart rate, contractility, and blood pressure, thereby reducing myocardial oxygen demand. The combination thus counteracts the nitrate-induced reflex tachycardia while producing complementary reductions in preload and afterload/oxygen demand, giving better anginal control than either drug alone.
1 Antianginal Drugs
Other Years Asked
1 Mr. X, a 65-year-old retired teacher had severe retrosternal chest pain radiating to
shoulder and left arm. He was profusely sweating and his ECG revealed ST elevation
and a diagnosis of Acute Myocardial infarction was made.
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walking, which is relieved on taking rest.
Classify drugs that are useful in this condition.
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