Adverse effects 

Nitrates 
– Headache, hypotension, dizziness, lightheadedness, tachycardia, palpitations 

Beta-adrenergic blocking agents
– hypotension, bradycardia, bronchospasm, congestive heart failure 

Calcium channel blockers 
– hypotension, dizziness, lightheadedness, weakness, peripheral edema, headache, congestive heart failure, pulmonary edema, nausea, and constipation 

Drugs that increase effects of Antianginal drugs 
• Antihypertensive 
• Diuretics 
• Phenothiazine antipsychotic agents
• Cimetidine 
• Digoxin 

Drugs that decrease effects of Antianginal
• Adrenergic drugs - epinephrine 
• Anticholinergic 
• Calcium salts 
• Phenobarbital, Phenytoin

Adjunctive Antianginal Drugs

In addition to antianginal drugs, several other drugs may be used to control risk factors and prevent progression of myocardial ischemia to myocardial infarction and sudden cardiac death.

These may include:
• Aspirin. This drug has become the standard of care because of its antiplatelet (ie, antithrombotic) effects. Recommended doses vary from 81 mg daily to 325 mg daily or every other day; apparently all doses are beneficial in reducing the possibility of myocardial reinfarction, stroke, and death. Clopidogrel 75 mg/day,
Is an acceptable alternative for individuals with aspirin allergy.

• Antilipemics. These drugs may be needed by clients who are unable to lower serum cholesterol levels sufficiently with a low-fat diet. Lovastatin or a related “statin” is often used. The goal is usually to reduce the serum cholesterol level below 200 mg/dL and lowdensitylipoprotein cholesterol to below 
130 mg/dL.

• Antihypertensives. These drugs may be needed for clients with hypertension. Because beta blockers and calcium channel blockers are used to manage hypertension as well as angina, one of these drugs may be effective for both disorders.

Examples of calculations of doses of vasoconstrictors

Ratio concentrations represent grams per millilitre

1:100,000 = 0.01 mg/mL or 10 µg/mL

1:200,000 = 0.005 mg/mL or 5 µg/mL

1:50,000 = 0.02 mg/mL or 20 µg/mL

1 cartridge of epinephrine 1:200,000 = 9 µg

1 cartridge of epinephrine 1:100,000 = 18 µg

1 cartridge of epinephrine 1:50,000 = 36 µg

1 cartridge of levonordefrin 1:20,000 = 90 µg

Methods of general anesthesia

CIRCLE SYSTEM

*HIGH-FLOW

FRESH GAS FLOW > 3 l/min.

*LOW-FLOW

FGF ok. 1l/min.

*MINIMAL-FLOW

FGF ok. 0,5 l/min.

Cephalosporins

Produced semisynthetically by chemical attachment of side chains to 7-aminocephalosporanic acid. Same mode of action , same resistance mech. 
But tend to be more resistant than penicillins to certain beta –lactamases .

GENERATION BASED ON :
-- BACTERIAL SUSCEPTIBILITY PATTERNS
-- RESISTANCE TO BETA –LACTAMASES
--NOT EFFECTIVE AGAINST -MRSA , L. MONOCYTOGENES , C. DIFFICLE , ENTEROCOCCI

First Generation 

Parentral

- CEPHALOTHIN
- CEFAZOLIN

Oral

- CEPHALEXIN
- CEPHRADINE
- CEFADROXIL

Second Generation

Parentral

CEFUROXIME
CEFOXITIN

Oral

CEFACLOR
CEFUROXIME AXETIL

Third Generation

Parentral

CEFOTAXIME 
CEFTIZOXIME
CEFTRIAXONE 
CEFTAZIDIME
CEFOPERAZONE

Oral 

CEFIXIME 
CEFPODOXIME
CEFDINIR 
CEFTIBUTEN

Fourth Generation

Parentral

CEFEPIME
CEFPIROME

Methyl salicylate

also known as oil of wintergreen, betula oil, methyl ester) is a natural product of many species of plants Structurally, it is methylated salicylic acid It is used as an ingredient in deep heating rubs

Glitazones (thiazolidinediones)

Thiazolidinediones, also known as the "-glitazones"

pioglitazone
rosiglitazone

Mechanism

bind to nuclear receptors involved in transcription of genes mediating insulin sensitivity
peroxisome proliferator-activating receptors (PPARs)

↑ insulin sensitivity in peripheral tissue
↓ gluconeogenesis
↑ insulin receptor numbers
↓ triglycerides

Clinical use

type II DM
as monotherapy or in combination with other agents
contraindicated in CHF
associated with increased risk of MI (in particular rosiglitazone)